Integration between primary and secondary services in the care of the severely mentally ill: patients' and general practitioners' views.
BACKGROUND
Communication between secondary and primary care is an important aspect of continuity of care. We investigated communication between general practitioners (GPs) and psychiatric teams about a representative group of patients with severe mental illness (SMI). We also sought views on GP involvement in care from the patients and their GPs.


METHODS
One hundred patients with SMI were randomly selected from those under the care of two psychiatric sector teams in inner London. The patients and their GPs were interviewed.


RESULTS
GPs' knowledge about the care their patients received was limited. Most GPs perceived their role as providing physical care and prescribing. Few patients consulted GPs for mental health care. GPs perceived themselves as less involved in the care of Black Caribbean or Black African patients.


CONCLUSIONS
Considerable discontinuities of care between secondary and primary care were identified. GP involvement in the care of patients with SMI appears limited. Better communication is necessary if care is to be shared.
Bindman
J
J
Institute of Psychiatry, London.
Johnson
S
S
Wright
S
S
Szmukler
G
G
Bebbington
P
P
Kuipers
E
E
Thornicroft
G
G
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008131:London / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010348:Patient Care Team; D017060:Patient Satisfaction; D010821:Physicians, Family / Q000523:psychology; D011364:Professional Practice; D012737:Sex Factors