Variables associated with general practitioners taking on serious mental disorder patients.
BACKGROUND
As part of community-based initiatives to strengthen integrated care and promote patient recovery, GPs are asked to play a greater part in treating serious mental disorder (SMD) patients. All current healthcare reforms favour the reinforcement of primary care. More information on enhancing the role of GPs in mental health would benefit policymakers, especially as regards SMD patients, where little research has been published as yet. This article assesses variables associated with GPs taking on SMD patients.


METHODS
The study, encompassing multiple sites, is based on a sample of 398 GPs, representative of the GP population in the Canadian province of Quebec. GPs were asked to answer a 143-item questionnaire on their socio-demographic and clinical practice profiles, patient characteristics, perceived inter-professional relationships and quality of care. Descriptive, bivariate and multivariate analyses were performed.


RESULTS
Our data highlighted that GPs currently followed up only a minority of SMD patients on a continuous basis and far fewer for both physical and mental health problems. A linear regression model that accounts for 43% of the variance was generated. The best variables associated positively with GPs taking on SMD patients were: frequency of referrals for joint follow-up with other resources, and involvement in post-hospitalization follow-up. Conversely, lack of expertise in mental health (related in our model to frequency of mental disorder patient transfer due to insufficient mental health training) is associated with a lower incidence of GPs taking on patients.


CONCLUSIONS
As advocated in current healthcare reforms, our study confirms the need to promote greater GP involvement in integrated care models and enhance their training in mental health--thereby helping to reverse the trend among GPs of transferring SMD patients to specialized care. Patients with stable SMDs ought to have the same care access as the general population.
Fleury
Marie-Josée
MJ
Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Quebec, Canada. flemar@douglas.mcgill.ca
Bamvita
Jean-Marie
JM
Tremblay
Jacques
J
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011792:Quebec; D017678:Sex Distribution; D011795:Surveys and Questionnaires