全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Continuing Care for Mentally Stable Psychiatric Patients in Primary Care: Patients' Preferences and Views

DOI: 10.1155/2012/575381

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objective. To investigate the preferences of psychiatric patients regarding attendance for their continuing mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting. Methods. 150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semistructured questionnaire designed to assess the objectives of the study. Results. 145 patients completed the questionnaire giving a response rate of 97%. Ninety-eight patients (68%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason given by patients in this category was fear of substandard quality of psychiatric care from their general practitioners (GPs) (67 patients, 68.4%). Twenty-nine patients (20%) preferred to attend their GP for continuing mental health care. The reasons given by these patients included confidence in GPs, providing same level of care as psychiatrist for mental illness (18 patients or 62%), and the advantage of managing both mental and physical health by GPs (13 patients, 45%). Conclusion. Most patients who attend specialised psychiatric services preferred to continue attending specialized psychiatric services even if they become mentally stable than primary care, with most reasons revolving around fears of inadequate psychiatric care from GPs. 1. Introduction In Ireland community mental health care consultations are provided by both primary care and specialised public mental health services. However, unlike the specialised public mental health service consultations, primary care service consultations are not currently free for the majority of Irish residents. Patients on the lowest end of the socioeconomic ladder qualify for state “medical or GP visit cards” which are a form of state health insurance that entitles the holder to receive free primary care consultations in addition to the universally free public specialist mental health consultations. All other patients including those with private health insurance pay for all primary care consultations which average around 60 dollars per consultation. A detailed description of the structure of both primary care and community mental health service provision in Ireland, as well as the proportions of patients with medical/GP visit cards and private health insurance and the packages received by these patients have been given in two related publications [1, 2]. The delivery of mental health services presents several important challenges to

References

[1]  V. I. O. Agyapong, C. Conway, and A. Guerandel, “Psychiatrists' views on shared care between specialised psychiatric services and primary care,” International Journal of Psychiatry in Medicine, vol. 42, no. 3, pp. 297–315, 2011.
[2]  V. I. O. Agyapong, C. Conway, and A. Guerandel, “Shared care between specialized psychiatric services and primary care: the experiences and expectations of consultant psychiatrists in Ireland,” International Journal of Psychiatry in Medicine, vol. 42, no. 3, pp. 295–313, 2011.
[3]  H. Rodenburg, V. Bos, C. O'Malley, P. McGeorge, T. Love, and A. Dowell, “General practice care of enduring mental health problems: an evaluation of the Wellington Mental Health Liaison Service,” New Zealand Medical Journal, vol. 117, no. 1202, 2004.
[4]  Primary Care-A New Direction, Quality and Fairness-A Health System for You-Health Strategy, http://www.dohc.ie/publications/pdf/primcare.pdf?direct=1.
[5]  G. Strathdee and M. King, “The interface between primary and secondary psychiatric care,” in The Scope of Epidemiological Psychiatry: Essays in Honour of Michael Shepherd, P. Williams, G. Wilkinson, and K. Rawmsley, Eds., pp. 420–433, Routledge, London, UK, 1989.
[6]  G. Mitchell, C. Del Mar, and D. Francis, “Does primary medical practitioner involvement with a specialist team improve patient outcomes? A systematic review,” British Journal of General Practice, vol. 52, no. 484, pp. 934–939, 2002.
[7]  J. B. Brown, B. Lent, A. Stirling, R. S. W. Jatinder Takhar, and J. Bishop, “Caring for seriously mentally ill patients: qualitative study of family physicians' experiences,” Canadian Family Physician, vol. 48, pp. 915–920, 2002.
[8]  A Vision for change-Report of the expert group on mental health policy, http://www.dohc.ie/publications/pdf/vision_for_change.pdf?direct=1, 2010.
[9]  H. Rodenburg, V. Bos, C. O'Malley, P. McGeorge, T. Love, and A. Dowell, “General practice care of enduring mental health problems: an evaluation of the Wellington Mental Health Liaison Service,” New Zealand Medical Journal, vol. 117, no. 1202, 2004.
[10]  T. Kendrick, B. Sibbald, T. Burns, and P. Freeling, “Role of general practitioners in care of long term mentally ill patients,” British Medical Journal, vol. 302, no. 6775, pp. 508–510, 1991.
[11]  M. Copty and D. L. Whitford, “Mental health in general practice: assessment of current state and future needs,” Irish Journal of Psychological Medicine, vol. 22, no. 3, pp. 83–86, 2005.
[12]  T. Burns, N. Greenwood, T. Kendrick, and C. Garland, “Attitudes of general practitioners and community mental health team staff towards the locus of care for people with chronic psychotic disorders,” Primary Care Psychiatry, vol. 6, no. 2, pp. 67–71, 2000.
[13]  J. Bindman, S. Johnson, S. Wright et al., “Integration between primary and secondary services in the care of the severely mentally ill: patients' and general practitioners' views,” British Journal of Psychiatry, vol. 171, pp. 169–174, 1997.
[14]  V. Agyapong, O. Ahmodu, and A. Guerandel, “Multidisciplinary team review to identify mental health patients who could be managed in primary care,” Irish Journal of Psychological Medicine, vol. 28, no. 3, pp. 138–140, 2011.
[15]  L. Gask, “Overt and covert barriers to the integration of primary and specialist mental health care,” Social Science and Medicine, vol. 61, no. 8, pp. 1785–1794, 2005.
[16]  C. Crosse, “A meaningful day: integrating psychosocial rehabilitation into community treatment of schizophrenia,” Medical Journal of Australia, vol. 178, supplement 9, pp. S76–S78, 2003.
[17]  L. Watters, M. Gannon, and D. Murphy, “Attitudes of general practitioners to the psychiatric services,” Irish Journal of Psychological Medicine, vol. 11, no. 1, pp. 44–46, 1994.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133