Rural primary care providers' perceptions of their roles in the provision of mental health services: voices from the plains

Abstract

Much has been written about the deficiencies of primary care providers in their treatment patterns, referral patterns and training for treating people with mental disorders. However, there is a growing realization that, regardless of these shortcomings, primary care providers will continue to be sought out by patients for care of mental disorders, due to patient preference, lack of alternatives or other reasons. Thus, a more recent focus has been on improving the link between primary care providers and mental health specialists. This may include integrated clinics, telecommunication links or simply enhancing the competency of primary care providers through clinical practice guidelines, utilization of screening instruments and greater contact with mental health professionals. Conspicuously absent from most of these studies, commissioned reports and policy papers is the voice of the rural primary care provider. Perhaps due to their heavy practice schedules, little has been written from their perspective. Accordingly, this paper presents the findings from a focus group held in early 1998, of a group of rural primary care providers who practice on the Western plains. It is in this forum that these providers discuss how they perceive their role, their treatment and referral patterns and their feelings and relationships with psychiatrists and the mental health system.