title: Collaboration between general practitioners (GPs) and mental healthcare professionals within the context of reforms in Quebec.
abstract: Background In the context of the high prevalence and impact of mental disorders worldwide, and less than optimal utilisation of services and adequacy of care, strengthening primary mental healthcare should be a leading priority. This article assesses the state of collaboration among general practitioners (GPs), psychiatrists and psychosocial mental healthcare professionals, factors that enable and hinder shared care, and GPs' perceptions of best practices in the management of mental disorders. A collaboration model is also developed. Methods The study employs a mixed-method approach, with emphasis on qualitative investigation. Drawing from a previous survey representative of the Quebec GP population, 60 GPs were selected for further investigation. Results Globally, GPs managed mental healthcare patients in solo practice in parallel or sequential follow-up with mental healthcare professionals. GPs cited psychologists and psychiatrists as their main partners. Numerous hindering factors associated with shared care were found: lack of resources (either professionals or services); long waiting times; lack of training, time and incentives for collaboration; and inappropriate GP payment modes. The ideal practice model includes GPs working in multidisciplinary group practice in their own settings. GPs recommended expanding psychosocial services and shared care to increase overall access and quality of care for these patients. Conclusion As increasing attention is devoted worldwide to the development of optimal integrated primary care, this article contributes to the discussion on mental healthcare service planning. A culture of collaboration has to be encouraged as comprehensive services and continuity of care are key recovery factors of patients with mental disorders.
authors.affiliation: Associate Professor, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, Canada.
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Fleury
authors.forename: Armelle
authors.initials: A
authors.lastname: Imboua
authors.forename: Denise
authors.initials: D
authors.lastname: Aubé
authors.forename: Lambert
authors.initials: L
authors.lastname: Farand
keywords: GP mental healthcare practice; collaborative care; mental disorders; mental primary healthcare; shared care