Médecins omnipraticiens : pratiques et intégration des soins en santé mentale au Québec

Abstract

Cet article examine le profil sociodémographique des médecins omnipraticiens (MO), leur rôle dans la prise en charge des troubles mentaux (transitoires/modérés, graves/persistants) dans les différents territoires (urbain, semi-urbain ou rural) du Québec, et si la pratique clinique et de collaboration de ces derniers est orientée vers une intégration des services de santé mentale. Cette étude transversale est basée sur 398 MO représentatifs de l’ensemble des MO du Québec qui répondaient à un questionnaire. L’étude révèle que les MO jouent un rôle central en santé mentale. Le profil sociodémographique et de pratique diffère selon les territoires. Les types de territoire et le degré de gravité du trouble mental influencent la propension des MO à intégrer les soins de santé mentale. Enfin, les MO pratiquent majoritairement en silo, mais soutiennent un renforcement de l’intégration des services de santé mentale. Les auteurs concluent que pour favoriser l’intégration des services de santé mentale, des incitatifs plus proactifs devraient être soutenus par les élites politiques et adaptés en fonction de la gravité des cas et des milieux. La pénurie des ressources, particulièrement frappante en milieu rural et l’insuffisance de mécanismes d’aide à la décision clinique, réduisent néanmoins les relations interprofessionnelles et limitent sérieusement l’intégration du dispositif de soins.This article examines the socio-demographic profile of general practitioners (GPs), their role in the management of (transient/moderate, severe/chronic) mental health disorders in different areas (urban, semi-urban, and rural) of Quebec as well as if their clinical practice and collaboration are oriented towards integration of mental health services. This crosswise study is based on 398 GPs representative of all Quebec GPs who answered a questionnaire. The study shows that GPs play a central role in mental health. According to territories, they have different socio-demographic and practice profiles. The types of territory and the degree of severity of mental health illnesses influence the propensity of GPs to integrate mental health care. Finally, GPs practiced mostly in silo, but they support greater integration of mental health services. The authors conclude that to improve mental health services integration, more proactive incentives should be favoured by political elites, adapted to the severity of the case and environments (urban, semi-urban or rural). However, the shortage of resources that is particularly striking in rural areas as well as inadequate mechanisms for clinical decision, reduce inter-relations and seriously limit the integration of healthcare.Este artículo examina el perfil sociodemográfico de los médicos generales (MG), su papel en el cuidado de los trastornos mentales (transitorios/moderados, graves/persistentes) en los diferentes territorios (urbano, semiurbano o rural) de Quebec, y si la práctica clínica y colaboración de estos últimos se orienta hacia una integración de los servicios de salud mental. Este estudio tra...

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