Shared care between specialised psychiatric services and primary care - the experiences and expectations of consultant psychiatrists in Ireland

Abstract

Objective

The study aims to explore the views of consultant psychiatrists in Ireland on shared care between specialist psychiatric services and primary care.

Methods

A self-administered questionnaire was posted to all 470 consultant psychiatrists working in Ireland. Self addressed envelopes were included for the return of completed questionnaires. Data was analysed using descriptive statistics and ANOVA

Results

213 questionnaires were returned giving a response rate of 45%. 47.9% of the respondents were male and 52.1% were female. Over all, 91% of respondents reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 85% reported that they foresaw difficulties for patients in implementing such a policy, including: increased financial burden on some patients (66%), lack of adequate allied health professionals resources in primary care (60%) and GP's not adequately trained to provide psychiatric care (52%). Most psychiatrists did not feel comfortable to transfer the care of patients with schizophrenia or bipolar disorder to their GP's and Child psychiatrists were significantly less comfortable than other psychiatrists to discharge patients with Depression, Bipolar Disorder, Anxiety Disorder, Alcohol Dependency Syndrome and Personality Disorder into the care of GP's after they have been stabilised in their medication.

Conclusion

Although most psychiatrists in Ireland would support a policy of shared care, they identify several constraints which would currently hamper the effective implementation of a policy of active collaboration between primary care and specialised psychiatric services in Ireland.