title: [Mental Health in General Family Medicine - obstacles and expectations perceived by Family Physicians].
abstract: This study seeks to understand the difficulties experienced by family physicians (FP) in the management of mental disorders (MD) and their proposals to improve the quality of care. It is qualitative study with semi-structured interviews with ten family physicians. These were recorded, transcribed and their content analyzed. Eight thematic categories were identified: perceived working conditions and available resources; perceived level of training in mental health; therapies used for treatment of MD; mental health instruments used in consultation; MD addressed in Primary Health Care (PHC) and referral to hospitals; patient's reaction to referral; articulation of PHC with hospitals; proposals to improve mental health care in PHC. Articulation with the Mental Health Services suffers from lack of accessibility, one-way communication and delayed response. The FP propose creation of consultancies; multidisciplinary teams in the community; creating a two-way communication platform; continuous learning through discussion of cases. The FP have responsibilities in providing MHC. This requires working in a multidisciplinary team. Services should be organized to function as a learning system that allows the progressive improvement of the professionals and the improvement of the interfaces between them.
authors.affiliation: USF Carcavelos, ACES de Cascais. R. Tenente Coronel Melo Antunes. 2775 Cascais Portugal. josemendesnunes@gmail.com.
authors.forename: Liliana
authors.initials: L
authors.lastname: Fernandes
authors.affiliation: USF Carcavelos, ACES de Cascais. R. Tenente Coronel Melo Antunes. 2775 Cascais Portugal. josemendesnunes@gmail.com.
authors.forename: Nuno
authors.initials: N
authors.lastname: Basílio
authors.affiliation: USF S. Julião, ACES Lisboa Ocidental e Oeiras. Lisboa Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Figueira
authors.affiliation: Faculdade de Ciências Médicas, Universidade Nova de Lisboa. Lisboa Portugal.
authors.forename: José Mendes
authors.initials: JM
authors.lastname: Nunes
mesh_terms: D000328:Adult; D005194:Family Practice / Q000379:methods* / Q000592:standards; D005260:Female; D058006:General Practice / Q000379:methods* / Q000592:standards; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration / Q000592:standards; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D010821:Physicians, Family / Q000592:standards / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D011787:Quality of Health Care; D012017:Referral and Consultation