Differing mental health practice among general practitioners, private psychiatrists and public psychiatristsReport as inadecuate

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BMC Public Health

, 5:104

First Online: 07 October 2005Received: 19 May 2005Accepted: 07 October 2005DOI: 10.1186-1471-2458-5-104

Cite this article as: Younès, N., Hardy-Bayle, M., Falissard, B. et al. BMC Public Health 2005 5: 104. doi:10.1186-1471-2458-5-104


BackgroundProviding care for mental health problems concerns General Practitioners GPs, Private Psychiatrists PrPs and Public Psychiatrists PuPs. As patient distribution and patterns of practice among these professionals are not well known, a survey was planned prior to a re-organisation of mental health services in an area close to Paris

MethodsAll GPs n = 492, PrPs n = 82 and PuPs n = 78 in the South-Yvelines area in France were informed of the implementation of a local mental health program. Practitioners interested in taking part were invited to include prospectively all patients with mental health problem they saw over an 8-day period and to complete a 6-month retrospective questionnaire on their mental health practice. 180 GPs 36.6%, 45 PrPs 54.9% and 63 PuPs 84.0% responded.

ResultsGPs and PrPs were very similar but very different from PuPs for the proportion of patients with anxious or depressive disorders 70% v. 65% v. 38%, p < .001, psychotic disorders 5% v. 7% v. 30%, p < .001, previous psychiatric hospitalization 22% v. 26 v. 61%, p < .001 and receiving disability allowance 16% v. 18% v. 52%, p < .001. GPs had fewer patients with long-standing psychiatric disorders than PrPs and PuPs 52%, 64% v. 63%, p < .001. Time-lapse between consultations was longest for GPs, intermediate for PuPs and shortest for PrPs 36 days v. 26 v. 18, p < .001. Access to care had been delayed longer for Psychiatrists PrPs, PuPs than for GPs 61% v. 53% v. 25%, p < .001. GPs and PuPs frequently felt a need for collaboration for their patients, PrPs rarely 42% v. 61%. v. 10%, p < .001.

Satisfaction with mental health practice was low for all categories of physicians 42.6% encountered difficulties hospitalizing patients and 61.4% had patients they would prefer not to cater for. GPs more often reported unsatisfactory relationships with mental health professionals than did PrPs and PuPs 54% v. 15% v. 8%, p < .001.

ConclusionGP patients with mental health problems are very similar to patients of private psychiatrists; there is a lack of the collaboration felt to be necessary, because of psychiatrists- workload, and because GPs have specific needs in this respect. The -Yvelines-Sud Mental Health Network- has been created to enhance collaboration.

List of abbreviationsGPsGeneral Practitioners.

PrPsPrivate Psychiatrists.

PuPsPublic Psychiatrists.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-5-104 contains supplementary material, which is available to authorized users.

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Author: N Younès - MC Hardy-Bayle - B Falissard - V Kovess - MP Chaillet - I Gasquet

Source: https://link.springer.com/

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