Mental Health and Your Primary Care Provider: What You Should Know

Many people do not realize that mental health care can start at a regular primary care visit. You do not need a separate referral or a specialist to begin getting help. Miranda Sirvinskas, a nurse practitioner (NP) at Riverside Internal Medicine, explains how mental health fits into everyday primary care (and why that matters).

Mental Health Care Starts at Every Visit

Mental health screening happens at every appointment at Riverside. "With every patient we see, we always screen for depression at every visit," Sirvinskas says. It begins with a short set of questions called the PHQ-2. Clinicians ask patients whether they have felt little interest in things or have been feeling down or hopeless in the past two weeks. If the answers raise concern, the conversation goes further.
Providers also use the GAD-7, a tool that screens for anxiety. Together, these help both the patient and provider get a clearer picture of what is going on. The most common concerns Sirvinskas sees are anxiety and depression. She also works with patients dealing with attention disorders like ADHD and ADD.

A Safe Space to Talk

For many people, bringing up mental health feels uncomfortable or even scary. Sirvinskas gets that. "Many patients are fearful in some way to bring up those issues," she notes. "They might feel ashamed or disappointed in themselves. I try to explain to everyone that they're not alone in this and it's necessary to talk about it and ask for help when it's needed."
Sirvinskas never rushes appointments. She listens carefully and lets patients guide their own care. Whether someone prefers therapy, medication, or both, the goal is always to find what works best for that person.

More Than Just "Feelings"

Mental health shows up in the body too. Anxiety can cause a racing heart, chest pain, shortness of breath, headaches, and stomach problems. Depression can bring fatigue, chronic pain, sleep trouble, and changes in appetite. 
"A lot of people see these symptoms and they don't realize it's related to anxiety or depression," Sirvinskas explains. "They think something else is going on. "This is why primary care is such a good first stop. Providers look at the full picture, physical and mental, and help connect the dots.

What Primary Care Can Offer

Primary care providers can prescribe medication for anxiety and depression. They can also refer patients to psychiatry for more complex conditions or to psychology for talk therapy. Most cases of anxiety, depression, mood disorders, and ADHD can be managed right in a primary care setting.

You Are Not Alone

If you are unsure about reaching out, here is something worth knowing. About 23% of adults in the U.S. experience a mental health condition each year. Nearly half of all Americans will meet the criteria for one at some point in their lives. "Patients should never feel alone," Sirvinskas emphasizes. Your primary care provider is often the easiest and fastest place to start. Visit the primary care provider page for more information. If you do not have one, visit the accepting new patients provider page to find a provider near you.

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