This paper starts from current interest in linkages between mental healthcare and primary care. After a brief historical and conceptual synthesis of this field, operational issues relating to de-institutionalization of care for people with mental disorders within primary healthcare settings are discussed. From analysis of some studies and experiences, the fundamental components for advancing in this direction are then highlighted: (1) development of communication processes that aim towards enhancing professional skills; (2) overcoming of the centralization around actions restricted to traditional settings; (3) maintenance of continual questioning regarding the risk of psychiatrization of mental healthcare; (4) overcoming of conceptions that place blame on family groups; and (5) investment in training for primary healthcare teams for the multiple dimensions of mental healthcare. Thus, some possible paths and directions for designing mental healthcare actions within primary care from a perspective away from the loony bin approach are pointed out.
Primary care; Psychiatric reform; Anti-loony bin movement; Family health; Mental health