Mental Health: Obstacles and expectations of Family Physicians

Abstract

Aims: The approach to psychiatric disorders in Primary Health Care is a constant concern because its high prevalence, comorbidities, and associated mortality. Barriers to mental health care that Family Physicians find in their daily practice are a focus for quality improvement. The authors investigated the difficulties experienced by Family Physicians in mental health care and their expectations in managing psychiatric disorders. Study Type: Observational Location: Health Centre Groups in Northern Portugal Population: Family Physicians Methods: Study conducted between July and November 2011, using a questionnaire prepared by the investigators completed by the participants Results: One hundred and thirty one physicians participated in the study. The main obstacles identified by family physicians in the management of psychiatric illness in primary care were inadequate time available for consultation (63% of participants identified this issue for scheduled consultations and 79% for non-scheduled consultations), lack of knowledge of referral criteria (49%), lack of communication skills (40%), and the reluctance of patients for referral to hospital (47%). The main expectations addressed were the creation of referral criteria (97%), better access to psychiatrists (60%) and psychologists (33%), enhanced interaction between Primary Care and Psychiatric services available in the referral area (93%) particularly through direct consultation (96%) and through clinical case conferences (73%). Conclusion: This study demonstrates the need for additional consultation time for mental health in primary care, additional investment in training to acquire specific knowledge and skills for mental health care, and provision of case conferences to increase understanding and awareness in this field.