Providing psychiatric backup to family physicians by telephone.
OBJECTIVE
To examine whether links between psychiatric services and family physicians can be strengthened and additional support provided for family physicians if a psychiatrist is available by phone to respond to clinical calls from family physicians.


METHODS
A psychiatrist, who visited 18 family physicians in 5 practices on a regular basis to provide clinical consultations, was available to provide telephone backup concerning mental health problems the family physicians encountered. All calls received by the psychiatrist were documented and analysed at the end of a 12-month period.


RESULTS
Over the course of one year, 128 calls were received from the 5 practices. Fifty were considered urgent, while 78 involved more routine management or medication issues. Telephone advice enabled the family physicians to handle these cases more effectively, often reducing utilization of other mental health services and providing support that was not otherwise available. The average time spent per call was 8 minutes, which meant the psychiatrist was only spending 20 minutes per week on the phone responding to family physicians' requests.


CONCLUSIONS
Providing telephone backup to family physicians is a time-efficient and effective method of supporting family physicians and reducing utilization of mental health services. It is applicable to psychiatrists working in any clinical setting.
Kates
N
N
Department of Psychiatry, McMaster University, Hamilton, Ontario.
Crustolo
A M
AM
Nikolaou
L
L
Craven
M A
MA
Farrar
S
S
D003299:Cooperative Behavior; D003419:Crisis Intervention / Q000379:methods / Q000706:statistics & numerical data; D017598:Efficiency, Organizational; D005194:Family Practice / Q000458:organization & administration / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration / Q000706:statistics & numerical data; D011570:Psychiatry / Q000379:methods* / Q000706:statistics & numerical data; D019114:Remote Consultation / Q000706:statistics & numerical data*; D016896:Treatment Outcome