Is there a case for mental health promotion in the primary care setting? A systematic review

Objectives: To evaluate the effectiveness of mental health promotion (MHP) interventions by primary health care professionals in the adult population. Methods: Systematic review of literature in English and Spanish for randomized controlled trials (RCTs) and observational studies evaluating the impact of interventions carried out by primary care professionals explicitly to promote and improve the overall mental health of adult patients. PubMed, PsycINFO, and Web of Science were independently searched by two investigators to identify all MHP articles from inception to October 2013 (no restrictions). Results: We retrieved 4262 records and excluded 4230 by a review of title and abstract. Of 32 full-text articles assessed, 3 RCTs were selected (2 in USA, 1 in UK); two focused on the mental health of parents whose children have behavioral problems, the other on older people with disabilities. One study reported a MHP intervention that improved participants' mental health at 6-month follow-up. All studies had low-moderate quality (2 of 5 points) on the Jadad Scale. Conclusion: There is a lack of implementation and/or evaluation of mental health promotion activities conducted by primary care professionals. More research is needed to clearly understand the benefits of promoting mental health in this setting.