This program has effectively integrated counsellors within primary care settings, increasing the capacity of primary care to handle mental health problems, strengthening links between providers from different sectors, and making mental health care more accessible.

Benefits of this approach include increased accessibility to psychiatric consultation, enhanced continuity of care, support for family physicians, and improved communication between psychiatrists and family physicians. This model, which has great potential for innovative approaches to continuing education and resident placements, demands new skills of participating psychiatrists.

Providing telephone backup to family physicians is a time-efficient and effective method of supporting family physicians and reducing utilization of mental health services. It is applicable to psychiatrists working in any clinical setting.

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This paper reviews the lessons learnt over the last five years by the Hamilton-Wentworth HSO Mental Health Program, an innovative program in Southern Ontario which brings counsellors and psychiatrists into the offices of 90 family physicians. The authors discuss the key reasons why the program has worked well and identifies key differences between primary care mental health services and traditional mental health services. It summarises new opportunities this approach opens up and looks at the applicability of this model in other settings.