Traditionally, mental health and physical health have been treated as separate entities with the medical specialty of psychiatry bridging the gap between these physical and mental realms. While one of the aims of primary care is to address a patient through a holistic perspective rather than as a constellation of diseases, primary care clinicians are not extensively trained to diagnose and treat psychiatric illnesses. Some studies have suggested that primary care providers underdiagnose psychiatric illness. Only 5% to 60% of depressed patients in primary care settings are correctly identified and treated. Furthermore only 22% of these physicians intend to attend CME on depression and fewer 8% intend to change their care of depressed patients in the next 6 months. Concurrently, the majority of patients with known psychiatric illnesses will receive care within a primary care setting. Another concern with the current paradigm is the deleterious effect stigma held by primary care providers has in creating a “major barrier” to seeking care or treatment participation.

To address this critical lack of education, the UC Davis / UC Irvine Train New Trainers Primary Care Psychiatry Fellowship was developed. It is a one-year longitudinal program with over 50 hours of instruction, and a curriculum that includes case-based tele-education, monthly mentoring sessions with faculty and traditional didactic training. Particularly groundbreaking is the additional program objective of training fellows to teach what they have learned to their primary care colleagues.