Response to Mahendran Letter

To the Editor: We thank Dr. Mahendran's attention to this concerning topic, as one of our goals for the article was to point out how psychiatric training and competence are sorely missing in a growing number of primary care physicians around the world for a diverse range of reasons. In China, this has been largely because of historical, political, and resource-limitation reasons, most notably for singling out psychiatry as a nonpriority in the delivery of a shorter, less intensive rural physician training program. The attendant significant negative impact over the years on the mental health of the country's rural population is well documented in our article. In Dr. Mahendran's report, this absence of competence is related to medical modernization that lost sight of the centrality of psychiatry as part of general medicine. We advocate that as psychiatrists, we cannot lose sight of this and should increase our championing of psychiatric training at all levels of medical education, lest psychiatry become irrelevant at the most basic level of medical care.