Primary care policy & practice for reducing inequalities in mental health

Mental health problems in individuals and in the Scottish population are less well defined by routine data and diagnostic criteria than are physical health problems, but they have similar relationships to social gradients. Primary care in Scotland in recent years has been given an emphasis on health inequalities and on prevention and is also increasingly expected to provide frontline services and ongoing support to patients with mental health problems. Addressing health inequalities and inequalities in mental health are thought to require action on social circumstances as well as on biological conditions. Policies express a general expectation that all public sector services have addressing health inequalities built in to their functions, but there is evidence to suggest that primary care has not yet found its place in meeting this expectation. To date there have been few concrete proposals for action and no guidelines for primary care to address inequalities in health or in mental health. The study set out to identify the contribution that primary care can make to reducing and preventing inequalities in mental health.