Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-26T17:57:29.510Z Has data issue: false hasContentIssue false
  • English
  • Français

Liaison psychiatry in rural general practice

Published online by Cambridge University Press:  13 June 2014

Vincent Russell ,
MacDara McCauley ,
John MacMahon ,
Sheila Casey ,
Heather McCullagh  and
Jillian Begley
Vincent Russell
Affiliation:
Cavan General Hospital, Cavan, Co. Cavan, Ireland
MacDara McCauley
Affiliation:
Central Mental Hospital, Dundrum, Dublin 14, Ireland
John MacMahon
Affiliation:
Kingscourt Surgery, Kingscourt, Co Cavan, Ireland
Sheila Casey
Affiliation:
Kingscourt Surgery, Kingscourt, Co Cavan, Ireland
Heather McCullagh
Affiliation:
Kingscourt Surgery, Kingscourt, Co Cavan, Ireland
Jillian Begley
Affiliation:
Virginia Surgery, Virginia, Co. Cavan, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

The recent government health strategy document described the integration between primary and secondary care in Ireland as often poor and outlined plans to redress this deficit. In mental health care, the gradual shift away from institutions over the past four decades has resulted in the GP becoming the most frequent professional contact for people with mental disorders. However, access to specialist opinion is usually available only for the fraction of psychiatric presentations which are formally referred to the psychiatric service.

On-site psychiatric liaison to primary care is commonly practised in other countries but not in Ireland. Research in the area suggests possible advantages for approaches which aim to enhance GPs' psychiatric skills while selectively encouraging referral of more serious disorders. This model has been adopted by GPs and psychiatrists in east Cavan and may be relevant to other similar settings, especially in the context of forthcoming changes in the organisation of primary care services.

Keywords

Liaison psychiatryMental health servicesPrimary careGeneral practice
Type
Perspectives
Information
Irish Journal of Psychological Medicine , Volume 20 , Issue 2 , June 2003 , pp. 65 - 68
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.The Psychiatric Services – Planning for the Future: Report of a study group on the development of the psychiatric services. Dublin: The Government's Stationary Office, 1984.Google Scholar
2.Shaping a Healthier Future. A strategy for effective healthcare in the 1990's. Department of Health, Dublin: The Government's Stationary Office, 1994.Google Scholar
3.Goldberg, D, Huxley, P. Common Mental Disorders – A Biopsychosocial Model. London: Routledge, 1991.Google Scholar
4.Halligan, P, Corcoran, P. The impact of patient suicide on rural general practitioners. Br J Gen Pract 2001; 51: 295–296.Google ScholarPubMed
5.Strathdee, G. The delivery of psychiatric care. J R Soc Med 1990; 83: 222–225.CrossRefGoogle ScholarPubMed
6.Strathdee, G. Psychiatrists in primary care: the general practitioner viewpoint. Fam Pract 1988; 5: 111–115.CrossRefGoogle ScholarPubMed
7.Barber, R, Williams, AS. Psychiatrists working in primary care: a survey of general practitioners' attitudes. Aust N Z J Psychiatry 1996; 30(2): 278–286.CrossRefGoogle ScholarPubMed
8.Maguire, N, Cullen, C, O' Sullivan, M, O'Grady-Walshe, A. What do Dublin GPs expect from a psychiatric referral? Ir Med J 1995; 88(6): 215–216.Google ScholarPubMed
9.Quality and Fairness – A Health System For You. Department of Health and Children, Dublin: The Government's Stationary Office, 2001.Google Scholar
10.Primary Care – A New Direction. Department of Health and Children, Dublin: The Government's Stationary Office, 2001.Google Scholar
11.Shepherd, M, Cooper, B, Brown, Aet al.Psychiatric Illness in General Practice. Oxford: Oxford University Press, 1966.Google Scholar
12.Balint, M. The Doctor His Patient and the Illness. London: Pitman, 1957.CrossRefGoogle Scholar
13.Caplan, G. Principles of Preventative Psychiatry. New York: Basic Books, 1964.Google Scholar
14.Gibson, R, Forbes, JM, Stobart, IWet al.Psychiatric care in general practice: an experiment in collaboration. BMJ 1966; i: 1287–1289.CrossRefGoogle Scholar
15.Brook, A. An experiment in general practitioner – psychiatrist cooperation. J R Coll Gen Pract 1967; 13: 127–131.Google Scholar
16.World Health Organization. Psychiatry and Primary Medical Care. Copenhagen: WHO Regional Office for Europe, 1973.Google Scholar
17.Goldberg, D, Huxley, P. Mental Illness in the Community: The Pathway to Psychiatric Care. London: Tavistock, 1980.Google Scholar
18.Strathdee, G, Williams, P. A survey of psychiatrists in primary care: the silent growth of a new service. J R Coll Gen Pract 1984; 34: 615–618.Google ScholarPubMed
19.Pullen, IM, Yellowlees, AJ. Scottish psychiatrists in primary healthcare settings: a silent majority. Br J Psychiatry 1988; 153; 663–666.CrossRefGoogle ScholarPubMed
20.Corney, R. Links between mental health professionals and general practices in England and Wales: the impact of fundholding. Br J Gen Pract 1996; 46: 221–224.Google ScholarPubMed
21.Kendrick, T, Sibbald, B, Burns, Tet al.Role of general practitioners in the care of long-term mentally ill patients. BMJ 1991; 302: 508–510.CrossRefGoogle ScholarPubMed
22.Malone, K, Campbell, A, Binchy, I, Ryan, J. Primary care liaison psychiatry: selected consultation and periodic group discussion model-evaluation of a pilot scheme. Ir J Psychol Med 1992; 9: 134–135.CrossRefGoogle Scholar
23.Williams, P, Clare, A. Changing patterns of psychiatric care. BMJ 1981; 282: 375–377.CrossRefGoogle ScholarPubMed
24.Mitchell, A. Psychiatrists in primary health care settings. Br J Psychiatry 1985; 147: 371–379.CrossRefGoogle ScholarPubMed
25.Tyrer, P. Psychiatric clinics in general practice: an extension of community care. Br J Psychiatry 1984; 145: 9–14.CrossRefGoogle ScholarPubMed
26.Wilson, S, Wilson, K. Close encounters in general practice: experiences of a psychotherapy liaison team. Br J Psychiatry 1985; 146: 277–281.CrossRefGoogle ScholarPubMed
27.Creed, F, Marks, B. Liaison psychiatry in general practice: a comparison between the liaison attachment scheme and shifted out-patientclinic models. J R Coll Gen Pract 1989; 39: 514–517.Google Scholar
28.Glover, GR, Leese, M, Mc Crone, P. More severe mental illness is more concentrated in deprived areas. Br J Psychiatry 1999; 175: 544–548.CrossRefGoogle ScholarPubMed
29.Commander, MJ, Dharan, SP, Surtees, PG. Access to mental health care in an inner-city health district: Pathways into and within specialist psychiatric services. Br J Psychiatry 1997; 170: 312–316.CrossRefGoogle Scholar
30.Bindman, J, Johnson, S, Szmukler, G, Bebbington, P, Kuipers, E, Thornicroft, G. Intrgration between primary and secondary services in the care of the severely mentally ill: patients' and general practitioners' views. Br J Psychiatry 1998; 172: 95–96.Google Scholar
31.Nazareth, I, King, M, Davies, S. Care of Schizophrenia in general practice: the general practitioner and the patient. Br J Gen Pract 1995; 45: 343–347.Google ScholarPubMed
32.Barber, R, Williams, AS. Psychiatrists working in primary care: a survey of general practitioners' attitudes. Aust N Z J Psychiatry 1996; 30(2): 278–286.CrossRefGoogle ScholarPubMed
33.Stansfield S, A, Leek C, A, Travers, Wet al.Attitudes to community psychiatry among urban and rural general practitioners. Br J Gen Pract 1992; 42: 322–325.Google Scholar
34.Brown L, M, Tower, J E C. Psychiatrists in primary care: would general practitioners welcome them? Br J Gen Pract 1990; 40: 369–371.Google Scholar
35.Millar, M. Patient Satisfaction with general practice in Ireland. Ir Med J 2001; 94: 106–109.Google ScholarPubMed
36.Brown L, Met al.A comparison of referrals to primary care and hospital outpatient clinics. Br J Psychiatry 1988; 153: 168–173.CrossRefGoogle Scholar
37.Strathdee, Get al.A standardised assessment of patients referred to primary care and hospital psychiatric clinics. Psychol Med 1990; 20: 219–224.CrossRefGoogle ScholarPubMed
38.Gask, L, Sibbald, B, Creed, FEvaluating models of working at the interface between mental health services and primary care. Br J Psychiatry 1997; 170(1): 6–11.CrossRefGoogle ScholarPubMed
39.Bower, P, Sibbald, B. On-site mental health workers in primary care: effects on professional practice. The Cochrane Library, 2001; Issue 1.Google Scholar
40.Kates, Net al.Providing psychiatric backup to family physicians by telephone. Can J Psychiat 1997; 42: 955–959.CrossRefGoogle ScholarPubMed
41.Burns, T. Training for psychiatrists in general practice. In: Pullen, Iet al.(eds). Psychiatry and General Practice Today. London: The Royal College of Psychiatrists and The Royal College of General Practitioners, 1994.Google Scholar
42.Gask, L. Training for general practitioners in psychiatry. In: Pullen, et al (eds). Psychiatry and General Practice Today. London: The Royal College Of Psychiatrists, 1994.Google Scholar
43.Williams, K. Self-assessment of clinical competence by general practitioner trainees before and after a six-month psychiatric placement. Br J Gen Pract; 1998; 48: 1387–1390.Google ScholarPubMed
44.King, M (ed). Shared care of patients with mental health problems. Report of a joint working group of the Royal College of Psychiatrists and Royal College of General Practitioners (Occasional paper 60.) London: RCGP, 1993.Google Scholar
45.Webb, M, Mc Clennand, R, Mock, G. Psychiatric services in Ireland: North and South. Ir J Psych Med 2002; 19(1): 21–26CrossRefGoogle ScholarPubMed
46.Bailey, P, Russell, V. Restricting the use of thioridazine. Br J Gen Pract, 2002; 52: 499–500.Google ScholarPubMed
47.The East Cavan Project:A North Eastern Health Board – Community Initiative in Suicide Prevention Among Young Men. North Eastern Health Board, 2002.Google Scholar