Shared care between specialized psychiatric services and primary care - the experiences and expectation of primary care physicians in Ireland

Abstract

Objective

The study aims to explore the views of primary care physicians in Ireland on shared care of psychiatric patients between primary and secondary services.

Methods

A self-administered questionnaire was posted to a random cross-section primary care physicians working in Ireland. Data were compiled and analyzed using descriptive statistics and analysis of variance.

Results

145 out of 300 questionnaires were returned giving a response rate of 48%. Overall, 77.9% of respondents reported that they completed a psychiatric rotation as part of their general practice training. Most General Practitioners expressed confidence in their ability to recognize and manage psychiatric disorders in primary care (on a confidence scale of 1 to 5, mean was 3.97, SD 0.699). There was a statistically, significant difference in confidence scores between those who had took a rotation in psychiatry as part of their GP training and those who did not, with the former reporting higher scores (4.04 vs. 3.72, F = 1.801, t = 2.363, p = 0.02)Regarding shared care, 95.8% of GPs were in favour of a formal shared care policy; however 42.8% expressed reservations regarding the implications of implementing such a policy. The most frequently expressed concerns related to the lack of resources in primary care for psychiatric patients (55.9%), financial implications for some patients (48.3%), and concern over communication with psychiatric services (42%).

Conclusion

The majority of Primary Care physicians in Ireland would support a policy of shared care of psychiatric patients’; however they raise some concerns regarding practical implications of such a policy.