ABSTRACT
Healthcare professionals (HCPs) working in primary care settings encounter patients with mental illnesses. This chapter explores some of the ethical issues which HCPs may encounter when caring for patients with mental illness in a primary care setting. It discusses the diagnosis of mental illness in primary care, considering the benefits and harms of making such a diagnosis. The chapter focuses on confidentiality as a much rehearsed ethical topic in the context of mental health, because of the social stigma associated with psychiatric illness and because patient-centred confidentiality is a predominant concern in Western medicine. It examines the ways in which the HCP-patient relationship can be ethically distorted by mental illness and the consequent justice issues that arise when illness makes interaction with healthcare services chaotic. The chapter concludes by reflecting on the multiple roles that an HCP may have when caring for patient with mental health needs and the fine line between paternalism and abandonment, between HCP as societal guardian.
