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. 2013 Summer;17(3):14-7.
doi: 10.7812/TPP/13-033.

Mental health practice and attitudes of family physicians can be changed!

Dan MacCarthy  1 , Rivian Weinerman, Liza Kallstrom, Helena Kadlec, Marcus J Hollander, Scott Patten
Affiliations

Mental health practice and attitudes of family physicians can be changed!

Dan MacCarthy et al. Perm J. 2013 Summer.

Abstract

Objectives: An adult mental health module was developed in British Columbia to increase the use of evidence-based screening and cognitive behavioral self-management tools as well as medications that fit within busy family physician time constraints and payment systems. Aims were to enhance family physician skills, comfort, and confidence in diagnosing and treating mental health patients using the lens of depression; to improve patient experience and partnership; to increase use of action or care plans; and to increase mental health literacy and comfort of medical office assistants.

Methods: The British Columbia Practice Support Program delivered the module using the Plan-Do-Study-Act cycle for learning improvement. Family physicians were trained in adult mental health, and medical office assistants were trained in mental health first aid. Following initial testing, the adult mental health module was implemented across the province.

Results: More than 1400 of the province's 3300 full-service family physicians have completed or started training. Family physicians reported high to very high success implementing self-management tools into their practices and the overall positive impact this approach had on patients. These measures were sustained or improved at 3 to 6 months after completion of the module. An Opening Minds Survey for health care professionals showed a decrease in stigmatizing attitudes of family physicians.

Conclusions: The adult mental health module is changing the way participants practice. Office-based primary mental health care can be improved through reimbursed training and support for physicians to implement practical, time-efficient tools that conform to payment schemes. The module provided behavior-changing tools that seem to be changing stigmatizing attitudes towards this patient population. This unexpected discovery has piqued the interest of stigma experts at the Mental Health Commission of Canada.

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Figures

Figure 1.
Figure 1.
Overview of the adult mental health learning module. AP = action period; ASW = Antidepressant Skills Workbook; CBIS = Cognitive Behavioral Interpersonal Skills; DAI = Diagnostic Assessment interview; LS = learning session; PHQ-9 = 9-item depression scale of the Patient Health Questionnaire; SAQ = self-assessment questionnaire.
Figure 2.
Figure 2.
Family physicians’ ratings of the overall success and impact of the adult mental health module. FP = family physician; ns = not significant.
Figure 3.
Figure 3.
Family physicians’ confidence in providing mental health care at module completion and three to six months after training. FP = family physician; MH = mental health; ns = not significant.
Figure 4.
Figure 4.
Perceived improvement in patient work life after training. FP = family physician; ns = not significant.
See this image and copyright information in PMC

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