title: Shared care between specialized psychiatric services and primary care: the experiences and expectations of consultant psychiatrists in Ireland.
abstract: BACKGROUND
  Internationally, there has been a growing interest in the pursuit of collaborative forms of care for patients with enduring mental health difficulties.
  
  
  OBJECTIVE
  The study aims to explore the views of consultant psychiatrists in Ireland on shared care between specialized psychiatric services and primary care for patients with mental health difficulties.
  
  
  METHODS
  A self-administered questionnaire was designed and posted to 470 consultant psychiatrists who are members of the College of Psychiatry of Ireland. Stamped self-addressed envelopes were included for the return of completed questionnaires.
  
  
  RESULTS
  Overall, 213 questionnaires were returned, giving a response rate of 45%. Of the respondents, 194 (91%) reported that they would support a general policy on shared care between primary care and specialized psychiatric services for patients who are stable on their treatment. However, 181 (85%) reported that they foresaw difficulties for patients in implementing such a policy including: increased financial burden on some patients (141, 66%); some patients may lack confidence in GP care (100, 47%); primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (128, 60%); primary care providers are not adequately trained to provide psychiatric care (111, 52%); and lack of adequate cooperation between primary care and specialized mental health services (96, 45%).
  
  
  CONCLUSIONS
  The Irish government and the Colleges of General Practitioners and Psychiatrists in Ireland need to work together to remove the bottlenecks that hinder the active involvement of primary care in the management of patients with enduring mental health difficulties. Also, the health care systems need to be organized along a shared care model to facilitate effective collaboration between primary and specialized psychiatric services.
authors.affiliation: University of Dublin Trinity College and St. Patrick's University Hospital, Dublin, Ireland. israelhans@hotmail.com
authors.forename: Vincent I O
authors.initials: VI
authors.lastname: Agyapong
authors.forename: Catherine
authors.initials: C
authors.lastname: Conway
authors.forename: Allys
authors.initials: A
authors.lastname: Guerandel
mesh_terms: D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006801:Humans; D007494:Ireland; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D011570:Psychiatry / Q000458:organization & administration*; D011795:Surveys and Questionnaires