General practitioners and mental health staff sharing patient care: working model.
OBJECTIVE
The paper describes a shared care programme developed by mental health services and general practitioners for shifting patients with chronic psychiatric disorders to the care of a general practitioner. The programme is characterized by: (i) a dedicated mental health service general practitioner liaison position to manage the programme and provide support to both patients and doctors; (ii) a multidisciplinary care planning meeting that includes mental health staff, the patient, the general practitioner and a carer; and (iii) a jointly developed individual management plan that specifies patient issues, strategies to deal with these issues, persons responsible for monitoring and a review date.


METHODS
The shared care protocol, the results of a review of patient mental health indicators and general practitioner satisfaction with the programme are described.


RESULTS
Outcomes to date suggest that patients' mental health is not compromised and may be enhanced by transfer to general practitioners within the shared care model. Indicators of mental health outcomes (Health of the Nation Outcome Scale and Life Skills Profile scores) show improved patient symptomatology and functioning in most cases.


CONCLUSIONS
The programme fits the model of recovery-based mental health services and complies with current local, state and Commonwealth policies that encourage integrated and collaborative approaches by mental health services and general practitioners in delivering mental health care to persons with chronic mental illness.
Horner
Deborah
D
Hornsby Ku-ring-gai Ryde Division of General Practice, Sydney, NSW, Australia.
Asher
Kim
K
D001315:Australia; D019090:Case Management; D002908:Chronic Disease; D003156:Community Mental Health Services / Q000458:organization & administration; D005194:Family Practice / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D010346:Patient Care Management / Q000379:methods / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D011570:Psychiatry / Q000458:organization & administration; D012017:Referral and Consultation