Caring for depressed patients in rural communities: general practitioners’ attitudes, needs and relationships with mental health services

Abstract

The challenge for mental health services is to develop ways to collaborate more effectively with GPs in the provision of psychological services for depressed patients in rural communities.

Internet‐based mental health programs: A powerful tool in the rural medical kit

“…8,9 According to rural GPs the greatest need for mental health services relates to the provision of cognitive behavioural therapy (CBT) groups and patient education about depression. 10 Indeed two-thirds of practitioners report a high or extreme need for CBT support and half report such a need for 'patient education'. 10 Second, knowledge of agencies providing mental health services is poor among rural residents with only 40% of respondents in one study of a rural population being aware of where they could receive help for a mental health problem.…”

“…10 Indeed two-thirds of practitioners report a high or extreme need for CBT support and half report such a need for 'patient education'. 10 Second, knowledge of agencies providing mental health services is poor among rural residents with only 40% of respondents in one study of a rural population being aware of where they could receive help for a mental health problem. 11 Moreover, there is little trust in the quality of such services with more than half of respondents in the latter study believing that the available services were 'marginal' or 'poor'.…”

Primary Mental Healthcare and Integrated Services

“…There are mixed findings with regard to general practitioners' preparation and confidence in taking on patients with common mental disorder (Bathgate et al, 2001;Krupinski & Tiller, 2001). Similarly to our research, recent studies (Rockman et al, 2004;Wright et al, 2005; see also Fleury et al, 2009) show that general practitioners are comfortable treating most cases of common mental disorder, but experience difficulty treating personality disorders, eating disorders, substance-abuse disorders, and young patient with mental disorder. For substance abuse co-morbidity and some cases of refractory and recursive common mental disorder, general practitioners also expressed a need for psychiatric expertise for evaluation and diagnosis, medication follow-up, and specialized intervention: generally, these are the three reasons that are reported in the literature for referral to psychiatric services (Rockman et al, 2004).…”

“…For substance abuse co-morbidity and some cases of refractory and recursive common mental disorder, general practitioners also expressed a need for psychiatric expertise for evaluation and diagnosis, medication follow-up, and specialized intervention: generally, these are the three reasons that are reported in the literature for referral to psychiatric services (Rockman et al, 2004). Some studies have cast doubt on the ability of general practitioners to diagnose and treat more complex forms of mental disorder, particularly major depression with suicidal tendency, schizophrenia, and bipolar disorder (Wright et al, 2005). In our research, few general practitioners managed patients with serious mental disorder on a consistent basis.…”

La réforme des soins primaires de santé mentale au Québec et le rôle et les stratégies de coordination des omnipraticiens

“…Ces constats concordent aussi avec les études internationales, où 90 % des troubles mentaux sont évalués comme pouvant être pris en charge des soins primaires (Dilts, Mann et Dilts, 2003 ;Wright, Harmon, Bowman, Lewin et Carr, 2005). Globalement, les troubles mentaux graves, les troubles de la personnalité, les troubles mentaux concomitants avec des troubles de dépendance aux substances psychoactives et les troubles mentaux chez les jeunes sont rapportés comme étant les troubles mentaux que les omnipraticiens se sentent les moins à l'aise à traiter, en raison de l'expertise exigée, mais aussi de la lourdeur de la prise en charge de ces cas et de la stigmatisation associée à ces patients.…”