Mental disorders and referrals to mental health specialists by general practitioners

Abstract

In a population study we analysed psychiatric help-seeking directed to general practitioners (GPs) and looked at who was referred to and received treatment from psychiatrists or psychologists. A random sample of 2015 persons were interviewed on a large number of variables, of which five groups were used in logistic regression analysis to find what accounted for (1) help-seeking addressed to GPs, (2) prior (not during the last 12 months) referral from GPs to, and treatment from, a psychiatrist or psychologist, and (3) current specialist referral/treatment (referral to/treatment from a psychiatrist/psychologist in the last 12 months). A total of 38 variables were covered in the areas of demographics, social support, life events and general well-being, and mental health (HSCL-25), with six personality-related variables. The conclusions are: (1) The strongest predictor of former and current help-seeking was high current symptom rating (HSCL-25). (2) Demographic variables played a limited role in explaining help-seeking. (3) Personality-related variables played a more important role in the referral/treatment groups than most demographic variables. Compared with those not being referred, people currently seeing or having seen a psychiatrist/psychologist described themselves as easily worried, but at the same time having an attitude of speaking out and of not accepting a below-par life situation.

General Practitioners' opinions on their practice in mental health and their collaboration with mental health professionals

“…GPs have rather negative attitudes towards them. Previous papers have noted that complicated depressive symptoms are frequently encountered in primary care [26-28] and PMHP are time-consuming and require particular skills [29]. But as shown in our study, managing PMHP is a key part of a GP's job, and a part they are willing to take on if sufficient support and expertise are available.…”

“…No publication on this point was found in the literature. Other studies conducted in ordinary practice have been focused on actual referrals from GPs to MHPro, or on actual utilization of mental health specialists, without reporting on GPs' perceived needs as is the case here [26,28,30,31]. Referral percentages have been estimated to be between 4 to 23% of primary care patients, and utilization of mental health specialists at 38% of depressed patients [26,30,31].…”

Changes in formal help seeking for psychological distress: The OsLof study

“…The cultural and social network of the individual also plays a role (11), especially perceived level of social support (12). The overall prevalence of psychological distress within the community also seems influential in determining help seeking, perhaps through more openness and political focus on the issue.…”

Do negative life experiences predict the health-care-seeking of adolescents? A study of 10th-year students in Oslo, Norway

“…Negative life events are among the factors that appear to increase consultations with family physicians (FPs) [2,3]. Common negative life experiences among young people, such as pressure to succeed, bullying, and exposure to physical violence are positively correlated with increased physical and psychological symptoms and illnesses [4 -6].…”