Sir: We have read the article “Community psychiatry in developing countries — a misnomer?” (Farooq & Minks, Psychiatric Bulletin, June 2001, 25, 226-227) with interest.
The content of the article is also very relevant to our country. The majority of patients live with their families and it is in this setting that almost all psychiatrists (grossly inadequate in number for the entire population) practise. A few reasonably organised community rehabilitation centres are available only in the major cities.
We agree fully that psychiatry in developing countries should be rooted in primary health care. With this in mind, the state health authorities in Sri Lanka have taken measures to place medical officers with a basic training in psychiatry in the hospitals, where there are no qualified psychiatrists, and the medical schools too have laid a greater emphasis on giving better training in psychiatry for undergraduates.
However, adopting the term ‘primary care psychiatry’ would not be prudent because primary care implies a basic level of care available to all (Declaration of Alma Ata) and would not include the greater degree of services that will have to be provided for those with psychiatric illness who live in the community. In this sense, the service provided should be more in line with the principles of community psychiatry, albeit somewhat different from that implemented in developed countries.
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