title: What do Dublin GPs expect from a psychiatric referral?
abstract: The advent of community psychiatry has tended to blur the interface between primary and secondary psychiatric care. We used a postal questionnaire to investigate each new referral from general practice to the public outpatient clinics of three West Dublin Psychiatric Sectors. 70 referrals, from 35 general practitioners, over a four month period in 1991 were analysed, regarding reason for referral and prior management in general practice. On average patients had seen their GP six times over a period of ten months. Mixed anxiety/depression was the most common diagnosis (23%). Medication had been prescribed for 61% of patients and 67% had counselling before referral. Common reasons for referral were: Access to therapies not available directly to the GP (30%); Failure of treatment (20%); To share the burden of chronic care (14%). In only 13% of referrals did the GP wish the psychiatrist to take over care. We conclude that the GPs surveyed undertake extensive pre-referral management of patients with psychological illness. They have well defined expectations of referral and are keen to follow up patients themselves. Future plans for community psychiatric services should take account of this pattern of care.
authors.affiliation: Dublin Regional Vocational Training Programme for General Practice.
authors.forename: N
authors.initials: N
authors.lastname: Maguire
authors.forename: C
authors.initials: C
authors.lastname: Cullen
authors.forename: M
authors.initials: M
authors.lastname: O'Sullivan
authors.forename: A
authors.initials: A
authors.lastname: O'Grady-Walshe
mesh_terms: D000342:Affective Symptoms / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D000553:Ambulatory Care; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy; D003158:Community Psychiatry; D003266:Continuity of Patient Care; D003376:Counseling; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy; D005194:Family Practice; D005500:Follow-Up Studies; D006801:Humans; D007400:Interprofessional Relations; D007494:Ireland; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D017211:Treatment Failure
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents