Primary Care Physicians' Experience With Mental Health Consultation

Kushner, Kenneth; Diamond, Ronald J.; Beasley, John W.; Mundt, Marlon; Plane, Mary Beth; K, Robbins

doi:10.1176/appi.ps.52.6.838

Cited by 31 publications

(22 citation statements)

References 7 publications

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“…Instead, the providers suggest that medication is the main treatment option they offer and rather than work with patient preferences and explanatory models of depression, they felt the need to “convince” patients that they have a depression and that depression is indeed a medical illness that warrants medical treatment. The need to treat with medication may reflect what primary care providers know best to do, but it may also reflect their dissatisfaction with referrals to mental health specialists (Gallo et al, 1999; (Kushner et al, 2001) and limited training in mental health (Williams et al, 1999). The providers in our sample additionally note that the need to convince older patients stems from the fact that their older patients appear more likely to hold a different explanation for their depression.…”

Section: Discussionmentioning

confidence: 99%

Negotiating depression treatment with older adults: Primary care providers' perspectives

Wittink

Givens

Knott

et al. 2011

Journal of Mental Health

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Section: Discussionmentioning

confidence: 99%

Negotiating depression treatment with older adults: Primary care providers' perspectives

Wittink

Givens

Knott

et al. 2011

Journal of Mental Health

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“…People with higher socio-economic status tend to use more psychiatrists and psychologists [15]. General practitioners offer care mainly to patients with common mental disorders, such as depression and anxiety [16]. Less is known about the differences between users of primary and specialized care in the general population.…”

Section: Introductionmentioning

confidence: 99%

Determinants Associated with the Utilization of Primary and Specialized Mental Health Services

et al. 2011

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The study aims to compare variables associated with the exclusive and joint use of primary and specialized care for mental health reasons by individuals diagnosed with a mental disorder in a Montreal/Canadian catchment area. Data were collected from a random sample (2,443 individuals). Among 406 people, diagnosed with a mental disorder 12 months pre-interview, 212 (52%) reported having used healthcare services. Compared to users of primary care only, people who sought both primary and specialized care presented more mental disorders and lower quality of life. People using only specialized healthcare received significantly less social support than persons using primary care exclusively and lived in neighborhoods with a high proportion of rental housing. Healthcare service provision should favor social networking and enable social cohesion and integration, particularly in neighborhoods with a high proportion of rental housing. Shared care and enhanced collaboration with other public and community-based resources should be encouraged.

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“…They also receive more support from their families, have fewer symptoms, are more functional, and use relatively few mental health care services compared with patients treated by psychiatrists [12]. Generally, GPs offer care mainly to patients with mental disorders such as depression and anxiety and request help from psychiatrists and other psychosocial professionals for more complex conditions [21,22]. …”

Section: Introductionmentioning

confidence: 99%

Professional Service Utilisation among Patients with Severe Mental Disorders

Fleury

Grenier

Bamvita

et al. 2010

BMC Health Serv Res

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Background Generally, patients with serious mental disorders (SMD) are frequent users of services who generate high care-related costs. Current reforms aim to increase service integration and primary care for improved patient care and health-care efficiency. This article identifies and compares variables associated with the use by patients with SMD of services offered by psychiatrists, case managers, and general practitioners (GPs). It also compares frequent and infrequent service use. Method One hundred forty patients with SMD from five regions in Quebec, Canada, were interviewed on their use of services in the previous year. Patients were also required to complete a questionnaire on needs-assessment. In addition, data were collected from clinical records. Descriptive, bivariate, and multivariate analyses were conducted. Results Most patients used services from psychiatrists and case managers, but no more than half consulted GPs. Most patients were followed at least by two professionals, chiefly psychiatrists and case managers. Care access, continuity of care, and total help received were the most important variables associated with the different types of professional consultation. These variables were also associated with frequent use of professional service, as compared with infrequent service use. In all, enabling factors rather than need factors were the core predictors of frequency of service utilisation by patients with SMD. Conclusion This study reveals that health care system organisation and professional practice - rather than patient need profiles - are the core predictors of professional consultation by patients with SMD. The homogeneity of our study population, i.e. mainly users with schizophrenia, recently discharged from hospital, may partly account for these results. Our findings also underscored the limited involvement of GPs in this patient population's care. As comorbidity is often associated with serious mental disorders, closer follow-up by GPs is needed. Globally, more effort should be directed at increasing shared-care initiatives, which would enhance coordination among psychiatrists, GPs, and psychosocial teams (including case managers). Finally, there is a need to increase awareness among health care providers, especially GPs, of the level of care required by patients with disabling and serious mental disorders.

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Primary Care Physicians' Experience With Mental Health Consultation

Cited by 31 publications

References 7 publications

Negotiating depression treatment with older adults: Primary care providers' perspectives

Negotiating depression treatment with older adults: Primary care providers' perspectives

Determinants Associated with the Utilization of Primary and Specialized Mental Health Services

Professional Service Utilisation among Patients with Severe Mental Disorders

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