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. 2010 May;5(4):90-104.

Clinical Practice Settings Associated with GPs Who Take on Patients with Mental Disorders

Marie-Josée Fleury  1 , Jean-Marie Bamvita, Denise Aubé, Jacques Tremblay
Affiliations

Clinical Practice Settings Associated with GPs Who Take on Patients with Mental Disorders

Marie-Josée Fleury et al. Healthc Policy. 2010 May.

Abstract
in English, French

In light of current reforms to reinforce primary mental healthcare and service integration, this paper assesses general practitioners' (GPs') management of patients with mental disorders (PMD) and its associated practice settings and clinical characteristics. The study is based on a survey of 398 Quebec GPs. Results showed that GPs who receive patients with moderate and transient mental disorders (PMD-M) usually follow them on a continuous basis; conversely, only a quarter of GPs who see patients with severe and persistent mental disorders (PMD-S) provide follow-up. With the exception of walk-in clinics, all clinical settings are associated with GPs who take on PMD-M. No setting was found to be significantly associated with GPs taking on PMD-S. Competency, skills and confidence seem to be core factors in decisions to take on PMD. Group practice models (CLSCs, network clinics) and shared-care initiatives should be encouraged to manage more complex PMD cases.

Dans la foulée des réformes actuelles qui visent à renforcer les soins primaires et l'intégration des services en matière de santé mentale, cet article évalue comment les omnipraticiens gèrent les patients présentant des troubles mentaux (PTM) ainsi que le lien avec les établissements de pratique et les caractéristiques cliniques. L'étude se fonde sur un sondage effectué auprès de 398 omnipraticiens du Québec. Les résultats montrent que les omnipraticiens qui reçoivent des patients présentant des troubles mentaux modérés ou transitoires (PTM-M) assurent habituellement le suivi sur une base continue; à l'inverse, seulement un quart des omnipraticiens qui reçoivent des patients présentant des troubles mentaux sévères et persistants (PTM-S) assurent le suivi. À l'exception des cliniques sans rendez-vous, tous les types d'établissements cliniques sont associés à des omnipraticiens qui acceptent des cas de PTM-M. Il n'y a pas d'association directe entre un type donné d'établissement et la prise en charge des PTM-S par les omnipraticiens. La compétence et la confiance des omnipraticiens envers leurs habiletés à prendre en charge les patients semblent être les facteurs centraux dans la décision d'accepter des cas de PTM. Les modèles de pratique de groupe (CLSC, cliniques-réseaux) et les initiatives de soins partagés devraient favoriser la gestion de cas plus complexes de PTM.

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FIGURE 1.
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