Collaboration Between Mental Health Services and Primary Care: The Bologna Project

Abstract

OVERVIEW: Management of anxiety and depressive disorders within the community necessitates collaboration between mental health services and primary care. While cooperative projects do exist in many countries, Italy's National Health System does not have a program designed to address this issue. In Bologna, a cooperative project arose as a spontaneous undertaking between mental health professionals and primary care physicians. A model of collaboration was designed specifically for the Italian National Health System, consisting of a network of primary care liaison services (PCLSs) instituted within the community mental health services. PCLSs are managed by a staff of specially trained mental health care professionals and are designed to facilitate communication between physicians, and they provide continual and multifaceted support consisting of diagnostic assessment and focused clinical intervention. PCLSs also provide formal consultation-liaison meetings and a telephone consultation service designed to promote communication and enrich diagnostic assessment and treatment. DISCUSSION: PCLSs are innovative, not only because they represent one of the first collaborative efforts in Italy to date, but also because of their innovative design, which is specific for the Italian National Health System. Overall, the project yielded a good result. Primary care physicians utilized the service extensively, and together with psychiatric personnel were satisfied with the outcome. These results, when compared with the traditional separation between the 2 services, are encouraging. Our model could be adapted for most communities in Italy, but must be preceded by shared recognition of local need.