Rethinking the Mental Health Treatment Skills of Primary Care Staff: A Framework for Training and Research

Health care reforms may offer several opportunities to build the mental health treatment capacity of primary care. Capitalizing
on these opportunities requires identifying the types of clinical skills that the primary care team requires to deliver mental
health care. This paper proposes a framework that describes mental health skills for primary care receptionists, medical assistants,
nurses, nurse practitioners, and physicians. These skills are organized on three levels: cross-cutting skills to build therapeutic
alliance; broad-based, brief interventions for major clusters of mental health symptoms; and evidence-based interventions
for diagnosis specific disorders. This framework is intended to help inform future mental health training in primary care
and catalyze research that examines the impact of such training.