Author Interview: Challenges in Primary Mental Health Care

Professors Christopher Dowrick (UK) and Christos Lionis (Greece), editors of the new WONCA book Challenges in Primary Mental Health Care: Models for Interdisciplinary Collaboration, spoke to WONCA News about why the book was needed, how it came together, and their hopes for the future of family medicine.

Why was this book needed now?

In today’s interconnected world, our collective well-being is shaped by a complex web of crises. Family medicine is facing many mental health challenges – from the everyday struggles we see in our patients to the wider disruptions of COVID-19, climate change, migration, and conflicts in many regions.

These crises are not isolated. They affect family doctors, other frontline physicians, and primary care practitioners everywhere. We wanted to make these challenges visible and provide guidance and support – equipping colleagues with the knowledge, recommendations, and skills to address this evolving range of global mental health issues.

How does this book build on your earlier work?

Our previous volume, Global Primary Mental Health Care, published in 2020, looked at the basic building blocks of mental health care in primary care: depression, dementia, unexplained physical symptoms, the mental health of young people, and more. That was the foundation.

This new book recognises that we are now living in an increasingly complicated, challenging world. Family doctors need both that earlier knowledge and new guidance on how to respond to the complex pressures our patients face today, and the pressures we ourselves experience in the consulting room.

What sparked the idea for this book?

Around two years ago we were confronted with overlapping crises – wars in Ukraine, Palestine and Sudan, growing evidence of climate change, and the ongoing effects of COVID-19. We've both worked for years on migration and displacement, and it was clear all of these issues were coming together. It’s what we call a “syndemic” – different crises interacting with each other. The question was: what can family doctors do? The risk is that we get overwhelmed, suffer compassion fatigue, and lose hope.

We began during the post-COVID period, with long COVID in front of us and conflicts escalating. A year later it was clear we were facing a cluster of crises. That confirmed for us that this was the right time to bring these issues together in one book.

What was it like working with so many contributors worldwide?

Chris: Working with a large group of doctors can feel like herding cats – we are busy, independent people with our own ways of working. But thanks to Christos’ patience and leadership, we were able to bring together a really stimulating group of contributors from many countries and backgrounds.

Christos: It was a learning process. We involved 17 contributors from across the world. The challenges of primary mental health care are not unique to one setting – they are common everywhere. That was one of the key lessons of this collaboration.

What is your hope for this book?

In our introduction we set out six key learning points. The final one is to maintain hope, even in very difficult circumstances – because without hope we are lost. This book is not just about ideas; it gives practical, down-to-earth ways to foster hope in our patients and in ourselves as practitioners.

We want to spread hope to frontline practitioners so they can pass it on to their patients. Meeting these challenges requires working together – not just doctors alone, but in collaboration with other health professionals, with patients and families, and with our communities. We hope the book will be used in practice and in universities, preparing the next generation with a collaborative approach to mental health care.

The book will be available for purchase at the conference, and can also be pre-ordered here: Pre-order the book

Explore other titles in the WONCA Family Medicine Book Series: See the full series