Detecting Child Psychiatric Disorders During Routine Clinic Work: A Pre-Interventional Study of Primary Care Physicians in Ilorin, Nigeria (Report‪)‬

Primary care physicians (PCPs) are the most accessible and affordable group of doctors in the health care system, and their gate-keeping role means that they care for all categories of patients, unrestricted by age, gender, organ or disease, as they enter, move through and re-enter the health care system. (1,2) PCPs therefore see large numbers of children and should play a significant role in childhood mental health. (3,4) Mental health problems are common in paediatric primary care clinics, where prevalence figures in the range of 10-30% have been reported. (5-7) The ability of PCPs to recognise and take appropriate decisions on child mental health conditions should therefore be of concern to psychiatrists, as the gate-keeping role is vital for the effective planning and organisation of child mental health programmes. Several reports suggest that PCPs do not identify child psychiatric problems adequately, and that when they do, they do not take appropriate decisions. (8-11) It has been suggested that this is due to perceived or actual lack of the necessary knowledge and skill, lack of sufficient interest, and a negative attitude. (1) The opportunities offered by the contact children and their mothers have with PCPs during their sometimes frequent visits to primary care centres are therefore often wasted as far as mental health care delivery is concerned. (2,12) The end result is sub-maximal psychosocial development of these children, and psychological problems that may get worse or be carried over into adult life with unfortunate consequences.