Irish General Practitioner referrals to psychological therapies

Cullinan, Veronica; Veale, Angela; Vitale, Agata

doi:10.1017/ipm.2015.17

Cited by 3 publications

(3 citation statements)

References 21 publications

(26 reference statements)

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“…The prevalence of mental health conditions in our study is lower than has been reported in an earlier Irish study (Cullinan et al 2016). Data for this trial were based on GPs' recall, which was measured using a 21-item questionnaire.…”

Section: Discussioncontrasting

confidence: 54%

The prevalence and treatment of mental health conditions documented in general practice in Ireland

O’Doherty

Hannigan

Hickey

et al. 2018

Ir. j. psychol. Med.

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ObjectivesAs prevalence of mental health disorders increases worldwide, recognition and treatment of these disorders falls increasingly into the remit of primary care. This study investigated the prevalence and management of adults presenting to their general practitioner (GP) in Ireland with a psychological condition.MethodsA random number function was used to select 100 patients with a consultation in the previous 2 years from 40 general practices around Ireland. The clinical records of these patients were examined using a standardised reporting tool to extract information on demographics, eligibility for free care, prevalence and treatment of psychological conditions.ResultsFrom a sample of 3845 ‘active’ patients, 620 (16%, 95% confidence interval 15–17%) had a documented psychological condition in the previous 2 years. The most common diagnoses were depression (54%) followed by stress and anxiety (47%). The following patient characteristics were associated with having a documented mental health condition: female gender; higher GP consultation rate; a referral or attendance at secondary care and eligibility for free GP care. Of those with a psychological condition, 34% received a psychological intervention and 81% received a pharmacological intervention.ConclusionsThe overall prevalence estimate of mental health disorders for this sample was lower than previously documented in primary care. Patients diagnosed with mental health disorders had higher utilisation of health services and pharmacological treatment was common.

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Section: Discussioncontrasting

confidence: 54%

The prevalence and treatment of mental health conditions documented in general practice in Ireland

O’Doherty

Hannigan

Hickey

et al. 2018

Ir. j. psychol. Med.

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“…Within primary healthcare, general practitioners (GPs) play a significant role in providing support for people experiencing a mental health problem, including facilitating access to psychotropic medications (Cullinan, Veale, & Vitale, ). GPs are the main access point to psychotropic medication and to specialist mental health services (Brunero, Jeon, & Foster, ).…”

Section: Introductionmentioning

confidence: 99%

Rural and metropolitan South Australian mental health workers’ views about nurse prescribing: A thematic analysis

Muyambi

Leach

Martinez

et al. 2018

Health Soc Care Community

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Almost one third of the South Australian population reside in regional locations, which are serviced by just 8% of the State's total psychiatrist workforce. Consequently, access to psychotropic medications in regional South Australia (SA) can be challenging. Granting prescribing rights to mental health nurses (MHNs) located in regional settings presents an opportunity to increase consumer access to psychotropic medications. The aim of the study was to understand the perspectives of mental health workers (MHWs) practising in regional and metropolitan settings towards MHN prescribing. The study adopted a qualitative approach. Seventeen MHWs participated in three focus groups, including two in regional SA and one in a metropolitan site within the State of SA. Participants reported difficulties in accessing medicines in regional areas. The regional focus groups indicated that MHN prescribing may help to release psychiatrists' time and provide quicker assessment and diagnosis. By contrast, the metropolitan focus group expressed reservations about MHN prescribing. Participants indicated that suitable governance structures supported by appropriate education programmes were a necessary prerequisite for MHN prescribing of psychotropic medications. MHN prescribing may help to mitigate the impact of psychiatrist shortages in regional South Australia and possibly in other areas of the world where recruitment is a challenge. The provision of adequate education and the establishment of a suitable governance and support framework are considered necessary steps to progress MHN prescribing.

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“…However, patients may lack knowledge about psychotherapy and psychotherapists (Thompson, Bazile, & Akbar, 2004). A study by Cullinan, Veale, and Vitale (2016) showed that GPs also have limited knowledge about specific psychotherapies. This could be due to physicians' medicalised understandings of the illness, despite research showing that doctors do recognise the influence of social factors in depression (McPherson & Armstrong, 2012).…”

Section: Depression Treatmentmentioning

confidence: 99%

Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

Teh¹

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This thesis examines the role of patient and doctor perspectives in primary care depression management. The analytical term chosen to explore these perspectives is Kleinman's explanatory model (EM), defined as "notions about an episode of sickness and its treatment that are employed by all those engaged in the clinical process" (1980, p. 105). This research is exploratory and focuses mainly on patients, with input from a small number of general practitioners (GPs).I examine self-stigma in depression patients because there has been an attempt in recent years to reduce stigma by describing depression as a medical condition like diabetes. This may have decreased some public stigma, but the association between biomedical explanations for depression and patient self-stigma has not been studied in-depth. Self-stigma is the internalisation of negative stereotypes and prejudices about having mental illness and it can inhibit help-seeking and outcomes more than public stigma. Another factor that can influence depression outcomes is the therapeutic relationship between patient and their doctor. Studies report empathy and good communication as Quantitative analysis methods mainly consisted of non-parametric tests for differences between groups and strength of correlations. Interviews were analysed manually and with textual analysis software Leximancer.RQ1 results showed that most participants had a strong or moderate belief about whether biomedical and/or psychosocial factors caused their depression, and most EM beliefs did not change over time. RQ2 results indicated that biomedical belief was associated with lower helpseeking inhibition but also greater alienation. RQ3 results highlighted that endorsement of GPpatient cooperation was strongly positively correlated with communication effectiveness. Patient interviews yielded exemplars to illustrate these findings. RQ4 results from a paired study (n = 29) suggest that the GPs were aware of and concordant with their patient's EMs. Awareness appears to be more important in determining recovery than concordance. Incidentally, GP interviews showed that doctors mostly accorded importance to knowing their patient's EM but concordance was seen as less crucial.This thesis gives new understanding about depression EM beliefs that are associated with lower patient self-stigma and more effective GP-patient communication. Results from this research on awareness-concordance were not generalisable due to the small sample size, but future work with larger samples will undoubtedly yield more insights into the importance of EMs in primary care depression management.

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Irish General Practitioner referrals to psychological therapies

Cited by 3 publications

References 21 publications

The prevalence and treatment of mental health conditions documented in general practice in Ireland

The prevalence and treatment of mental health conditions documented in general practice in Ireland

Rural and metropolitan South Australian mental health workers’ views about nurse prescribing: A thematic analysis

Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

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