Dear Colleagues,

Psychiatric disorders are among the leading causes of disability worldwide. People suffering from mental illness may follow varied trajectories in terms of the level and quality of care they receive. Access to care varies from one location to another. Clinicians seek to apply the latest evidence-based treatments to these disorders in order to improve quality of life, but are often confronted with barriers along the way. In this Special Issue, we will focus on common psychiatric illnesses and give an overview of what constitutes both basic and comprehensive care for these disorders. We will then examine the potential barriers in implementing these models of stepped care. Recognition of these barriers is critical to bring a successful change in practices in order to offer patients the best possible treatments.

A general outline for each article covering each disorder chosen could answer some of the following questions (acknowledging that there is considerable geographic variability):

1. What is the expectation of treatment at the primary care level for this particular disorder?
   1. Education
   2. Screening
   3. Initiating treatment
   4. Referral
2. What are the goals of treatment?
   1. Symptoms reduction?
   2. Remission?
   3. Recovery?
   4. Restored QOL?
3. What are the general outcomes following treatment in primary care?
4. Which cases get referred to specialized care (psychiatry)?
5. Are there accepted, widely recognized treatment algorithms of care?
   1. Are clinicians aware of these guidelines?
   2. Do clinicians generally follow these guidelines?
6. What are the potential barriers to the implementation of next level of treatment at every step?
7. Are there expected timelines associated with each level of care in the algorithm?
8. When should we consider more invasive treatments in this algorithm?
   1. How do we decide on offering these treatments and how do we sequence them?
9. How often is a chronic illness model adopted in the treatment approach and what does this imply in terms of care?
10. What, if any, improvements can be made in our overall approach moving forward?

Dr. Theodore Kolivakis
Guest Editor

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