Psychiatry in general practice. A pilot scheme using the liaison-attachment model.
OBJECTIVE
To improve the quality and accessibility of psychiatric service in the primary care setting.


METHODS
Under the liaison-attachment model, a senior psychiatry trainee provided psychiatric consultations part-time in general practice over an 18-month period. Patients regarded by the participating doctors as having significant psychiatric problems were referred to the trainee for consultation.


METHODS
Four group general practices, involving 18 doctors, took part in the scheme.


METHODS
During the study 172 patients with a wide spectrum of diagnoses were assessed. Near the end of the 18-month period the participating general practitioners provided their evaluations of the scheme.


METHODS
In almost all cases standard treatment was provided in the primary care setting and administered by either a general practitioner, the trainee or both working collaboratively together.


METHODS
The general practitioners evaluated the results of the consultations and the effect of the service on their referral patterns. They also rated the overall impact of the scheme on their own knowledge and skills, the quality of care, and its accessibility.


RESULTS
The quality of outcome, if known, was regarded as satisfactory in 88% of cases. The reported frequency of referrals to psychiatrists in private practice dropped significantly. The participating doctors perceived improvements in their own abilities to deal with psychiatric problems and regarded the quality and accessibility of psychiatric care to be enhanced by the scheme.


CONCLUSIONS
The psychiatric liaison-attachment model, developed in Britain, is applicable and effective in the Australian primary care setting.
Carr
V J
VJ
Faculty of Medicine, University of Newcastle, NSW.
Donovan
P
P
D001315:Australia; D005194:Family Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D001523:Mental Disorders / Q000628:therapy; D010821:Physicians, Family / Q000523:psychology; D010865:Pilot Projects; D011320:Primary Health Care; D011570:Psychiatry; D012017:Referral and Consultation / Q000706:statistics & numerical data