The psychiatrist in primary care : let's look before we leap.
Irish psychiatrists may begin to spend, as their British have counterparts have, at least some of their time delivering a psychiatric service from primary care settings.
It was therefore decided to review the origins and development of attitudes towards and outcome of this practice in Britain.
A literature search and review of relevant papers was undertaken.
Collaboration between psychiatrists and general practitioners began to expand significantly in the 1970s and 1980s.
Three main models are used, the shifted outpatient model, the selected consultation model and the liaison-attachment team model.
The shifted out-patient model is liked by patients whose attendance rate is better at such clinics and in some areas this model has resulted in a fall in hospital admission rates.
There is a paucity of papers examining outcome of the other models.
Results of the one extensively studied team liaison approach reports higher treated prevalence rates and lower admission rates for those patients referred.
There was no effect on detection of illness by GPs and the service was much moan costly.
While some benefits may result from use of the shifted out-patient approach, they are not compelling enough to enable a firm recommendation for its widespread implementation to be made.
The results to date suggest the team-liaison approach does not produce benefits sufficient to outweigh the increased cost.
Mots-clés Pascal : Psychiatre, Travail équipe, Médecin généraliste, Soin santé primaire, Consultation psychiatrique, Organisation santé, Service santé, Santé mentale, Article synthèse, Homme, Irlande, Europe
Mots-clés Pascal anglais : Psychiatrist, Team work, General practitioner, Primary health care, Psychiatric consultation, Public health organization, Health service, Mental health, Review, Human, Ireland, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0195680
Code Inist : 002B18H04. Création : 09/06/1995.