Seeing the Whole Person: Why Mental Health Needs More Than the Medical Model
For most families, a primary care physician (PCP) or a pediatrician is the first person they turn to when something feels off. This could be when a child’s behavior changes, a teen’s sleep deteriorates, or an adult can’t shake persistent headaches. Many people do not show up saying, “I think I’m depressed” or “My child may be anxious.” Instead, mental distress often enters the room wearing the clothes of physical symptoms. That’s why PCPs and pediatricians sit at such a critical crossroads of mental health: they’re trusted, they’re accessible, and they’re trained to recognize patterns. Yet their training is fundamentally medical. They screen, they diagnose, they manage within brief visits. This medical model, which grew out of a history of treating mental illness as a disease of the body rather than a complex interplay of mind, environment, and culture, shapes not only how care begins but also what happens next.
Screening tools like the PHQ-9, GAD-7, or Vanderbilt ADHD Questionnaire have become routine in primary care, and developmental checklists are common in pediatrics. These are important advances. They legitimize mental health concerns and normalize early detection. They are also blunt instruments. Medical training gives PCPs and pediatricians only a snapshot of the vast landscape of psychological well-being. Beyond a short psychiatry rotation, most receive little in-depth education about trauma, cultural context, or clinical therapeutic practices. As a psychologist, I see the this tension up close and the consequences of that regularly. I once listened to a primary care physician tell a group of community workers that PCPs and pediatricians are equipped to handle mental illness on their own and usually don’t need the support of psychiatrists or psychologists. That perspective is more common than many people realize. While physicians are absolutely essential in identifying and initiating care, mental health is complex and layered. No matter how well-intentioned, a medical provider’s training is not designed to replace the years of study and practice psychologists and licensed therapists undergo.
Another example that stays with me is providers who start a medication, offer a few words of reassurance, and hope symptoms improve without realizing the depth of what they’re treating. A patient spent ten years in the care of a PCP who managed their psychiatric medications, switching prescriptions repeatedly as symptoms lingered. There was no referral to a psychiatrist for medication expertise, no psychologist for therapy or deeper assessment. After a decade, the patient finally landed in a psychologist’s office. Only then, through therapy and a broader lens, did they gain the insight and tools to truly shift their mental state. Ten years of lost time, time that could have been used to heal, because a system encouraged one provider to do it all.
Ethically, this places a heavy responsibility on medical providers to know the limits of their expertise and to refer out when necessary. Psychologists, and licensed therapists spend years immersed in human behavior, assessment, and intervention. We approach mental health not only as a set of symptoms but as a story embedded in family, history, and community. We’re trained to explore how stigma, identity, and culture shape what depression or anxiety even looks like, and how interventions must adapt accordingly. When primary care and mental health professionals collaborate, coordinating treatment and honoring families’ values, the result is care that is both comprehensive and respectful.
I’ve also seen this positive collaboration, models that get it right. A pediatrician’s office I worked with screened not only the child’s development but also the parents’ mental, physical, financial, and even legal health at every appointment. They had nurses and case managers assigned to follow up, connecting families with community resources and mental health supports. It was holistic care in practice, recognizing that a child’s well-being is inseparable from the stability of their caregivers.
Another positive model comes from integrated primary care clinics where psychologists, social workers, and physicians share the same space. In one clinic, a teenager presenting with frequent stomachaches could be seen by the pediatrician and, in the same visit, referred down the hall to a behavioral health consultant for immediate support. Families didn’t have to navigate referrals, waitlists, or insurance hurdles alone. They left the appointment with a clearer understanding of the problem and a care plan that included both medical and mental health perspectives.
But that kind of collaboration is not the norm. Our systems fragment care. Insurance reimburses quick medical visits far more readily than extended therapy sessions. Waiting lists for specialists can be months long. Stigma and cultural misunderstanding compound these barriers. In some communities, mental illness is still framed as weakness, sin, or family shame. In others, language for distress may be somatic rather than emotional, which can confuse screening tools designed for a different cultural lens. Without cultural competence on the part of providers, medical or mental health, people can be misdiagnosed or undertreated. The medical model’s emphasis on diagnosis and medication can inadvertently reinforce the very stigma it aims to reduce, making mental health feel like a label rather than a continuum of human experience.
This doesn’t mean the medical model has no place in mental health. It’s the reason we have insurance coverage for depression and ADHD. It’s why pediatricians screen for postpartum depression in new mothers. It allows a busy working parent to get started on medication for panic attacks without waiting months for a specialist. These are real, tangible benefits. But the model also has real limitations: it compresses complex human suffering into fifteen-minute appointments, privileges medication over psychotherapy, and struggles to integrate social, cultural, and preventive factors into care.
For the public, the takeaway is this: a medical provider is an important first stop, but it’s rarely the whole journey. If your symptoms persist after a brief screening or a prescription, or if you sense there’s more going on than can be addressed in a primary care visit, that’s the time to seek a mental health professional. Psychologists, therapists, and psychiatrists bring different but complementary expertise: deep assessment, ongoing therapy, and nuanced medication management and we can work alongside your doctor rather than replace them. Ideally, you shouldn’t have to choose between medical and mental health care. You should be able to expect a team that speaks to one another and honors the full complexity of your life.
Our challenge as a field is to move beyond a one-size-fits-all medical model without discarding its strengths. That means training doctors to recognize not just symptoms but stories. It means making cultural competence and trauma-informed care standard, not optional. It means reducing stigma by acknowledging that mental health is both medical and social, biological and relational. And it means building systems that allow PCPs, pediatricians, psychologists, therapists, psychiatrists, and communities to collaborate rather than compete. Only then will we offer the kind of care people actually need. The kind that sees them as whole human beings, not just diagnoses.
