title: Collaboration between primary care and psychiatric services: does it help family physicians?
abstract: OBJECTIVE
  To compare family physicians' reports of their experiences managing patients with psychiatric disorders in settings with and without access to collaborative mental health services.
  
  
  METHODS
  Survey using a questionnaire adapted from a similar study in Australia. Family physicians were asked about their knowledge, skills, and degree of comfort in managing the following psychiatric disorders derived from the primary care version of the 10th edition of the International Classification of Diseases: psychosis, depression, anxiety, childhood disorders, and stress-related disorders. We also compared the 2 groups of physicians regarding their satisfaction with mental health services in general.
  
  
  METHODS
  The Capital District Health Authority (CDHA) in Nova Scotia.
  
  
  METHODS
  All family physicians practising in the CDHA.
  
  
  METHODS
  Self-reported knowledge, skills, and degree of comfort in managing psychiatric problems; satisfaction with mental health services, adjusted for family physicians' demographics; and stated interest in mental health.
  
  
  RESULTS
  We received 101 responses (37 from physicians with access to collaborative care and 64 from physicians without access) from 7 communities in the CDHA. Family physicians who had access to collaborative care reported significantly greater knowledge in the areas of psychosis, alcohol or substance use, and childhood behavioural problems; and better skills in managing psychosis, alcohol or substance use, childhood depression or anxiety, childhood behavioural disorders, and relationship problems. Their comfort levels in managing relationship problems and childhood behavioural disorders were also significantly higher. Family physicians with access to collaborative care were significantly more satisfied with mental health services, over and above shared care. All these differences remained significant after controlling for sex, level of interest in mental health, and years in practice.
  
  
  CONCLUSIONS
  Family physicians with access to collaborative care reported greater knowledge, better skills, and more comfort in managing psychiatric disorders and greater satisfaction with mental health services. Further work is needed to establish why this is so and to determine any effect on patient outcomes, such as symptoms, quality of life, and psychosocial functioning.
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada. Stephen.Kisely@cdha.nshealth.ca
authors.forename: Stephen
authors.initials: S
authors.lastname: Kisely
authors.forename: Debbie
authors.initials: D
authors.lastname: Duerden
authors.forename: Susan
authors.initials: S
authors.lastname: Shaddick
authors.forename: Ajantha
authors.initials: A
authors.lastname: Jayabarathan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services; D008875:Middle Aged