Psychiatric services in primary care: specialized or not?

Abstract

We compare referrals made to a psychiatric service by two comparable general practices. One practice made its referrals through conventional channels; the other referred patients to a multi-professional team who saw patients at a clinic held on the practice premises. The members of the team and the general practitioners in the second practice also met regularly to discuss matters of mutual interest. More patients were referred by this method, which also made greater use of the multiple disciplines involved in psychiatric care.Patients referred through conventional channels were more likely to have had previous contact with the psychiatric service, were more likely to be admitted to hospital and spent 70 per cent more time as inpatients.These results confirm the findings of other workers in demonstrating that there are tangible benefits in a multidisciplinary specialist team working in primary care.