Are Primary Care Physicians Equipped to Help Persons with Depression? An Exploration of Knowledge, Attitudes and Practices in Kingston, Jamaica

Abstract

Objective: To explore the knowledge, attitudes and practices (KAP) of primary care physicians with regard to depression, as well as the association of personal and professional factors with these parameters. Method: Through a self-administered questionnaire, all 42 public sector primary care physicians in the Jamaican parishes of Kingston and St. Andrew were surveyed on their demographic characteristics, medical training and career trajectory, as well as on KAP parameters related to depression. Possible associations among the KAP parameters and other variables were explored with non-parametric statistical tests. Statistical significance was taken at p < 0.05.Results: Two-thirds of physicians felt that they were not adequately trained to deal with depression and less than 20% routinely screened patients with chronic illnesses for depression. Overall, positive attitudes towards persons with depression were prominent.However, negative attitudes towards persons with depression were encountered more commonly among foreign nationals and among persons who had received their medical training overseas (p< 0.05). Physicians earlier in their careers had a greater tendency to view the prescription of antidepressant medications as the exclusive purview of mental health specialists (p< 0.05). Conclusion:There is scope for further training and sensitization of primary care physicians on issues related to depression. Persons earlier in their careers may benefit from particular emphasis on attitudes towards the management of depression. Foreign nationals and overseas-trained physicians may benefit from particular emphasis on attitudes towards persons with depression.

Cross-sectional mixed-methods study protocol exploring the enablers and barriers for people with severe and enduring mental illness in Jamaica when accessing healthcare for chronic physical illness

“… 51 56 However, a recent study identified that few primary care physicians (16.7%) screen for depression, with the majority (66.7%) reporting they felt ill-equipped to manage depression despite demonstrating adequate knowledge. 57 The findings from this study suggest that primary physicians may have sufficient knowledge to assess for mental health conditions, but lack the capacity to undertake the ongoing management of this group. This is noteworthy as an earlier study conducted among CPI inpatients revealed that 60.5% experienced depressive symptoms 58 and it is unclear what percentage received treatment for these symptoms.…”

A qualitative exploration of the health system responses to the screening and management of comorbid mental illness and chronic physical illness in Jamaica

“…Despite these policy advances in Jamaica, there is little published research showing its translation into practice with one recent study suggesting that 66.7% of PCPs are either inadequately trained or lack the confidence to detect and manage MI such as depression [ 15 ]. Consequently, the present study sought to explore and describe the attitudes, perspectives, experiences, and practices of health policymakers and clinicians regarding the screening and management of patients with comorbid MI and CPI in primary care settings in Jamaica.…”