Primary care mental health – A new direction?

Russell, Vincent; Kelly, Martina

doi:10.1017/s0790966700001063

Cited by 4 publications

(5 citation statements)

References 15 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This will enhance joint clinical problem solving, as well as drafting and implementation of local joint care guidelines (Russell & Kelly, 2010;Fuller et al 2011). As part of the systematic approach, evidence supports using visits to GP surgeries by 'link-workers' (mental health practitioners) -recently launched by the Newry and Mourne PMHC -to promote further collaboration between GPs and PMHC.…”

Section: Discussionmentioning

confidence: 99%

Improving general practitioners’ referral details of antidepressant use for patients referred for depression to primary mental health care: re-audit

Towobola¹,

Cunningham²,

Cotter³

2015

Ir. j. psychol. Med.

View full text Add to dashboard Cite

Background. This audit cycle looked at details of antidepressants given in general practitioners' (GPs) referral letters to Primary Mental Health Care (PMHC). With adequate information when patients are referred, time spent in clarifying details could be put into better use by clinicians and prompt effective treatment would help to reduce the direct and indirect costs of depression.Objective. To evaluate how effective our intervention was 7 months after a previous audit and identify areas that need improvement.Method. Audit of 33 referral letters of patients referred for depression from GPs to a PMHC service in Northern Ireland, followed by the intervention (feedback and pro forma) and re-audit after 7 months.Results. The April audit showed 100% documentation of current antidepressant treatment and dose, but showed poor documentation of previous antidepressant use (33%), dose or duration (15%) and the reason for stopping the treatment (3%). Following intervention, the re-audit showed 25% and 24% rise in documenting previous antidepressant used and maximum dose reached, respectively, and 20% rise in documenting the reason for stopping.Conclusions. Our interventions made modest improvement in providing relevant data in referral letters. This study adds to the existing evidence that relying mainly on feedback as a method of implementing change is ineffective. Lack of enthusiasm for using the newly introduced pro forma suggests that mental health services should obtain more effective ways of engaging GPs in service development. Using a systematic approach, which includes identifying local barriers to change and providing a supportive environment are important before the next re-audit.

show abstract

Section: Discussionmentioning

confidence: 99%

Improving general practitioners’ referral details of antidepressant use for patients referred for depression to primary mental health care: re-audit

Towobola¹,

Cunningham²,

Cotter³

2015

Ir. j. psychol. Med.

View full text Add to dashboard Cite

show abstract

“…The first author (VR), who led the project, had provided psychiatric consultation, on-site, in primary care settings in Canada and Ireland. 34 35 In a preliminary planning meeting, VR outlined details of the PIPC service and its evaluation at both health clinics. In explaining the operation of the PIPC service, it was emphasised that all primary care clinicians were invited to refer primary care patients with suspected CMDs.…”

Section: Methodsmentioning

confidence: 99%

Clinician perceptions of common mental disorders before and after implementation of a consultation-liaison psychiatry service: a longitudinal qualitative study in government-operated primary care settings in Penang, Malaysia

Russell

Loo²,

Walsh

et al. 2021

BMJ Open

Self Cite

View full text Add to dashboard Cite

ObjectivesTo explore primary care clinician perceptions of barriers and facilitators in delivering care for common mental disorders (CMD) before and after implementation of a consultation-liaison psychiatry service (Psychiatry in Primary Care (PIPC)) in government-operated primary care clinics and to explore the clinicians’ experience of the PIPC service itself.DesignThis longitudinal qualitative study was informed by the Normalisation Process Model and involved audiotaped semi-structured individual interviews with front-line clinicians before (Time 1) and after (Time 2) the PIPC intervention. The Framework Method was used in the thematic analysis of pre/post interview transcripts.SettingTwo government-operated primary care clinics in Penang, Malaysia.Participants17 primary care medical, nursing and allied health staff recruited purposely to achieve a range of disciplines and a balanced representation from both clinics.InterventionPsychiatrists, accompanied by medical students in small numbers, provided one half-day consultation visit per week, to front-line clinicians in each clinic over an 8-month period. The service involved psychiatric assessment of patients with suspected CMDs, with face-to-face discussion with the referring clinician before and after the patient assessment.ResultsAt Time 1 interviewees tended to equate CMDs with stress and embraced a holistic model of care while also reporting considerable autonomy in mental healthcare and positively appraising their current practices. At Time 2, post-intervention, participants demonstrated a shift towards greater understanding of CMDs as treatable conditions. They reported time pressures and the demands of key performance indicators in other areas as barriers to participation in PIPC. Yet they showed increased awareness of current service deficits and of their potential in delivering improved mental healthcare.ConclusionsDespite resource-related and structural barriers to implementation of national mental health policy in Malaysian primary care settings, our findings suggest that front-line clinicians are receptive to future interventions designed to improve the mental healthcare capacity.

show abstract

“…19,48 The Irish Journal of Psychological Medicine has a strong tradition of highlighting and debating key issues in contemporary psychiatry, and this, too, will continue. In recent years, we have published occasional multi-author papers examining key issues, 49,50 and our regular editorials have explored diverse topics including deinstitutionalisation in disability services, 51 dementia care, 52 mental health and the asylum process, 53 psychiatric training and research, 54 reflective practice in psychiatric training, 55 primary care mental health 56 and perinatal psychiatry. 57 In March 2011, we published a special supplement dedicated to head shop drugs, 58,59 looking in detail at the clinical effects of mephedrone and other head shop drugs, 60,61 users' experiences of cathinones, 62 "whack" induced psychosis, 63 and benzlypiperazineinduced acute delirium.…”

Section: Founding Editor Of the Irish Journal Of Psychological Medicimentioning

confidence: 99%

The Irish Journal of Psychological Medicine and the College of Psychiatry of Ireland

Kelly

2012

Ir. j. psychol. Med.

View full text Add to dashboard Cite

Primary care mental health – A new direction?

Cited by 4 publications

References 15 publications

Improving general practitioners’ referral details of antidepressant use for patients referred for depression to primary mental health care: re-audit

Improving general practitioners’ referral details of antidepressant use for patients referred for depression to primary mental health care: re-audit

Clinician perceptions of common mental disorders before and after implementation of a consultation-liaison psychiatry service: a longitudinal qualitative study in government-operated primary care settings in Penang, Malaysia

The Irish Journal of Psychological Medicine and the College of Psychiatry of Ireland

Contact Info

Product

Resources

About