Impulse control disorders (ICDs) and conditions with impulse control features provide a challenge in terms of identification, treatment, and follow-up when mental health specialists are in short supply. Medical settings, in particular the largest, primary health care, provide an opportunity to address many impulse-affected conditions currently poorly assessed and treated in health care settings. Barriers to intervention for ICDs in primary health care are time constraints; understanding of the etiology, symptoms, and appropriate interventions; the health and social costs; and prioritizing of training in and treatment of conditions perceived as more serious or appropriate to a primary health care service. These barriers may possibly be overcome in primary care settings, and in this chapter, a model to address problem gambling is described.
Social-Economic and Cultural Barriers and Primary Health Care Service Delivery in Rural Communities in Abuja, Nigeria
