With the advent of managed care and the primary care gatekeeper, psychiatry's relationship to primary care is shifting.

Four recent surveys suggest that, in general, departments of psychiatry have done little to restructure their relationships with primary care.

This article proposes an agenda for developing primary care psychiatry programs in departments of psychiatry.

The rationale for shifting resources toward primary care psychiatry is followed by a discussion of the goals of primary care psychiatry programs.

The agenda presents specific high-priority projects in the areas of research, education, and clinical care, citing examples of existing initiatives and discussing the resources needed for funding primary care psychiatry programs.