Over the past three decades or so, there has been increasing evidence of common mental disorders (CMD) constituting a significant public health problem in India. Presenting themselves as somatic symptoms and associated with considerable morbidity including psychosocial disability, diminished productivity, economic and psychological costs for the affected, care givers and for society at large, the distress of CMD is however, often disguised and unrecognized. Studies have also reported that a significant proportion of patients in primary health care settings (PHCs) have CMD although they are not identified as such, since the PHCs are not designed or equipped with psychological service providers to deal with mental health concerns. This study reports on the prevalence of CMD, its association with socio-demographic factors, and the implementation of a psychosocial intervention called Brief Counselling in two PHCs in the city of Visakhapatnam in the southern state of Andhra Pradesh. Findings indicated a significantly high prevalence of CMD; fairly equal distribution of all three categories of physical health, psychological problems, and social and interpersonal concerns (such as domestic violence) across the sample, underscoring the fact that it is not physical health alone, but rather a range of underlying issues of distress that manifest as physical health complaints for which people consult PHC facilities; and the most frequently used counselling interventions, reflecting the needs of the sample, were ventilation, followed by problem-solving. The findings are discussed in the context of the intertwining and bidirectional linkages of multiple social and economic inequalities with the burden of psychological distress as seen at this level.