Care for patients with severe mental illness: the general practitioner's role perspective.
BACKGROUND
Patients with severe mental illness (SMI) experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored.


METHODS
A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'.


RESULTS
186 general practitioners distributed over urban areas (49%), urbanised rural areas (38%) and rural areas (15%) of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices.GPs also saw their role as giving support and information to the patient's family.However, they felt a need for recognition of their competencies when working with mental health care specialists.


CONCLUSIONS
GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.
Department of General Practice, University Medical Centre Groningen, Groningen, The Netherlands. m.j.t.oud@home.nl
Marian J T
MJ
Oud
Jan
J
Schuling
Cees J
CJ
Slooff
Klaas H
KH
Groenier
Janny H
JH
Dekker
Betty
B
Meyboom-de Jong
D001291:Attitude of Health Personnel; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008605:Mental Health Services; D015999:Multivariate Analysis; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods*; D011618:Psychotic Disorders / Q000628:therapy*; D012017:Referral and Consultation