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Psychiatrists in Primary Health Care Settings

Published online by Cambridge University Press:  29 January 2018

Alexander R. K. Mitchell
Alexander R. K. Mitchell*
Affiliation:
Fulbourn and Addenbrookes Hospitals, Cambridge, CB1 5EF
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Abstract

An increasing number of psychiatrists are now working partly in primary care settings. This paper describes how the movement began and how both psychiatrists and other members of the specialist psychiatric treatment team have explored ways of working with family doctors in the diagnosis and management of psychiatric disorders. Various styles of collaborative work, the declared advantages of such attachment schemes, the reservations being expressed about their further extension, and their research and educational potential are explored. If such enterprises, designed to help the family doctor identify psychiatric morbidity in the practice and to extend his skills in managing such patients and their relatives, are to be commended, they must be carefully monitored so that the cost-benefit balance can be established.

Type
Papers
Information
The British Journal of Psychiatry , Volume 147 , Issue 4 , October 1985 , pp. 371 - 379
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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References

Balint, M. (1957) The Doctor, His Patient and The Illness. London: Pitmans.CrossRefGoogle Scholar
Brandon, S. (1970) Crisis theory and the possibility of therapeutic intervention. British Journal of Psychiatry, 117, 627–633.CrossRefGoogle ScholarPubMed
Brook, A. (1967) An experiment in general practitioner-psychiatrist cooperation. Journal of the Royal College of General Practitioners, 13, 127–131.Google Scholar
Brook, A. & Temperley, J. (1976) The contribution of a psychotherapist to general practice. Journal of the Royal College of General Practitioners, 28, 86–94.Google Scholar
Brook, P. & Cooper, B. (1975) Community mental health care: primary team and specialist services. Journal of the Royal College of General Practitioners, 25, 93–110.Google ScholarPubMed
Browne, K. & Freeling, P. (1967) The Doctor–Patient Relationship. Edinburgh and London: Livingstone.Google ScholarPubMed
Caplan, G. (1970) The Theory and Practice of Mental Health Consultation. London: Tavistock Publications.Google Scholar
Carse, J., Panton, N. & Watt, A. (1958) A district mental health service: the Worthing experiment. Lancet, i, 39–41.CrossRefGoogle Scholar
Clare, A. & Davies, G. (1979) Psychiatry in general practice. In Essentials of Postgraduate Psychiatry (eds Hill, P., Murray, R. & Thorley, A. T.). London: Academic Press.Google Scholar
Clare, A. & Lader, M. (1982) Psychiatry and General Practice. London: Academic Press.Google Scholar
Clare, A. (1983) Psychiatry in general practice. Journal of the Royal College of General Practitioners, 33, 195–198.Google ScholarPubMed
Cooper, J. (1982) Psychiatrists and Primary Care in Nottingham. In Psychiatry and General Practice (eds Clare, A. & Lader, M.). London: Academic Press.Google Scholar
Corney, R. (1982) Social work in general practice. In Psychiatry and General Practice. London: Academic Press.Google Scholar
Corser, C. & Ryce, S. (1977) Community mental health care: a model based on the primary care team. British Medical Journal, 11, 936–938.CrossRefGoogle Scholar
De Alarcon, R., De Glanville, H. & Hodson, J. (1960) Value of the specialist's report. British Medical Journal, 11, 1663–1664.CrossRefGoogle Scholar
De Alarcon, R., & Hodson, J. (1964) Value of the general practitioner's letter. British Medical Journal, 11, 435–438.CrossRefGoogle Scholar
Farewell, T. (1976) Crisis intervention. Nursing Mirror, 142, 60–61.Google Scholar
France, R. & Robson, M. (1982) Work of the clinical psychologist in general practice: preliminary communication. Journal of the Royal Society of Medicine, 75, 185–189.CrossRefGoogle ScholarPubMed
Fry, J. (1984) “Screening”, paper presented at conference on “Mental Illness in Primary Care Settings”. Institute of Psychiatry, London, 17–18 July.Google Scholar
Gersons, B. (1984) The consultation relationship between psychiatry and general practice. World Psychiatric Association Symposium, Helsinki, Finland, June.Google Scholar
Gibson, R., Forbes, J. M., Stobart, I. W., Cooke, J. T., Jenkins, C. W., Mackeith, S. A., Rosenberg, L., Allchin, W. H. & Shepherd, D. (1966) Psychiatric care in general practice: an experiment in collaboration. British Medical Journal, i, 1287–1289.CrossRefGoogle Scholar
Goldberg, D. (1983) Reported in Hospital Doctor, 10 November, page 11.Google Scholar
Goldberg, D. & Blackwell, B. (1970) Psychiatric illness in general practice; a detailed study using a new method of case identification. British Medical Journal, 11, 439–443.CrossRefGoogle Scholar
Goldberg, D. Kay, C. & Thompson, L. (1976) Psychiatric morbidity in general practice and the community. Psychological Medicine, 6, 565–569.CrossRefGoogle ScholarPubMed
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community—The Pathway to Care. London: Tavistock Publications.Google Scholar
Gray, A. (1982) Tools for decision making. Health and Social Services Journal, 11 February, 184–186.Google Scholar
Harding, T., DE Arango, M. V., Baltazar, J., Climent, C. E., Ibrahim, H. H. A., Ladrigo-Ignacio, L., Srinwasa Murthy, R. & Wigg, N. N. (1980) Mental disorders in primary health care: a study of frequency and diagnosis in four developing countries. Psychological Medicine, 10, 231–241.CrossRefGoogle ScholarPubMed
Harker, P., Leopoldt, H. & Robinson, J. (1976) Attaching community psychiatric nurses to general practice. Journal of the Royal College of General Practitioners, 26, 666–671.Google ScholarPubMed
Higgs, R. (1984) Life changes. British Medical Journal, 288, 1556–1557.CrossRefGoogle ScholarPubMed
Horder, J. (1984) Professional Team Roles. Paper presented at conference on Mental Illness in Primary Care Settings, Institute of Psychiatry, London, 17–18 July.Google Scholar
Horder, J. Ellis, J., Hirsch, S., Lawrence, D., Marinker, M., Murray, D., Wakeling, A. & Yudkin, J. S. (1984) An important opportunity—an open letter to the General Medical Council. British Medical Journal, 288, 1507–1511.Google Scholar
Howie, J. (1979) Research in General Practice. London: Croom Helm.Google Scholar
Hunter, D. & McCance, C. (1983) Referrals to the psychiatric services by general practitioners in relation to the introduction of sessions by psychiatrists in health centres. Health Bulletin (Scotland), 41, 78–83.Google Scholar
Johnson, D. (1973) A further study of psychiatric outpatient services in Manchester: an operational study of general practitioner and patient expectations. British Journal of Psychiatry, 123, 185–191.CrossRefGoogle Scholar
Johnstone, A. & Goldberg, D. (1976) Psychiatric screening in general practice; a controlled trial. Lancet, 5, 605–608.CrossRefGoogle Scholar
Kaeser, A. & Cooper, B. (1971) The psychiatric patient, the general practitioner, and the outpatient clinic: an operational study and a review. Psychological Medicine, I, 312–325.CrossRefGoogle Scholar
Kessel, N. (1960). Psychiatric morbidity in a London general practice. British Journal of Preventative and Social Medicine, 14, 16–22.Google Scholar
Kessel, N. (1963) Who ought to see a psychiatrist? Lancet, i, 39–41.Google Scholar
Langsley, D. (1982) Primary care and psychiatry. Social Psychiatry, 17, 89–94.CrossRefGoogle Scholar
Lyons, H. (1969) Joint psychiatric consultations. Journal of the Royal College of General Practitioners, 18, 125–127.Google Scholar
Marinker, M. (1983) Should general practice be represented in the university medical school? British Medical Journal, 286, 855–859.CrossRefGoogle ScholarPubMed
Mcintosh, M. (1982) The clinical psychologist in practice. Psychiatry in Practice, I, (No. 9), 38–41.Google Scholar
Mckechnie, A., Philip, A. & Ramage, J. (1981) Psychiatric services in primary care: specialised or not: Journal of the Royal College of General Practitioners, 31, 611–614.Google ScholarPubMed
Mitchell, R. (1983a) Liaison Psychiatry in general practice. British Journal of Hospital Medicine, 30, 100–106.Google ScholarPubMed
Mitchell, R. (1983b) Psychiatrists and general practitioners; working together. Psychiatry in Practice, 2, (No. 17), 15–19.Google Scholar
Mitchell, R. (1983c) Psychiatrists and general practitioners: the dynamics of the referral. Psychiatry in Practice, 2, (No. 18), 13–19.Google Scholar
Mitchell, R. (1984a) A psychiatrist in the health centre. Update (Journal of Postgraduate General Practice), 28(10), 1192–1196.Google Scholar
Mitchell, R. (1984b) Psychiatrists and general practitioners: the tri-partite interview. Psychiatry in Practice, 3, (No. 23), 20–22.Google Scholar
Morrice, K. (1976) Crisis Intervention: Studies in Community Care. London: Pergamon.Google Scholar
Ottley, D. (1973) The role of social welfare and voluntary agencies in a comprehensive psychiatric service. In The Development of Comprehensive Health Services in the Community. Copenhagen: World Health Organisation.Google Scholar
Oxman, T. & Smith, R. (1980) Consultation-liaison psychiatry within a family practice. Social Psychiatry, 17, 101–107.CrossRefGoogle Scholar
Rawnsley, K. & Loudon, J. (1962) Factors influencing referral of patients to a psychiatrist by general practitioners. British Journal of Preventative and Social Medicine, 16, 174–182.Google ScholarPubMed
Robson, M., France, R. & Bland, M. (1984) Clinical psychologists in primary care: controlled clinical and economic evaluation. British Medical Journal, 288, 1805–1808.CrossRefGoogle ScholarPubMed
Rodger, W. (1973) Community psychiatry in the health care: a Devon development. The Practitioner, 210, 799–802.Google Scholar
Schniewind, H. (1977) A psychiatrist's experience in a primary health care setting. International Journal of Psychiatry in Medicine, 7, 229–240.CrossRefGoogle Scholar
Shepherd, M., Cooper, B., Brown, A. & Kalton, G. (1966) Psychiatric Illness in General Practice. London: Oxford University Press.Google Scholar
Shepherd, M., (1982) Psychiatric research in general practice—past, present and future. In Psychiatry and General Practice (eds Clare, A. & Lader, M.). London: Academic Press.Google Scholar
Sladden, S. (1979) Psychiatric Nursing in the Community: A Study of a Working Situation. Edinburgh: Churchill Livingstone.Google Scholar
Spector, J. (1984) Clinical psychology and primary care: some dilemmas. Bulletin of the British Psychological Society, 37, 73–76.Google Scholar
Spitzer, R. & Fleiss, J. (1974) A re-analysis of the validity of psychiatric diagnosis. British Journal of Psychiatry, 125, 341–347.CrossRefGoogle Scholar
Strathdee, G. (1984) “Patterns of collaboration”, paper presented at conference on “Mental Illness in Primary Care Settings”, Institute of Psychiatry, London, 17–18 July.Google Scholar
Strathdee, G. & Williams, P. (1984) A survey of psychiatrists in primary care: the silent growth of a new service. Journal of the Royal College of General Practitioners, 34, 615–618.Google ScholarPubMed
Tait, D. (1983) Shared care between psychiatry and general practice. Update (Journal of Postgraduate General Practice), 26(2), 177–184.Google Scholar
Teasdale, John D., Fennell, Melanie J. V., Hibbert, George A. & Amies, Peter L. (1984) Cognitive therapy for major depressive disorders in primary care. British Journal of Psychiatry, 144, 400–406.CrossRefGoogle ScholarPubMed
Tyrer, P. (1984) Psychiatric Clinics in general practice: an extension of community care. British Journal of Psychiatry, 145, 9–14.CrossRefGoogle ScholarPubMed
Tyrer, P. Seivewright, N. & Wollerton, S. (1984) General practice psychiatric clinics: impact on psychiatric services. British Journal of Psychiatry, 145, 15–19.CrossRefGoogle ScholarPubMed
Watts, C. (1966) Depressive Disorders in the Community. Bristol: Wright.Google Scholar
Williams, P. (1979) The interface between psychiatry and general practice. Smith, Kline A French Publications, 2, (No. 7).Google Scholar
Williams, P. & Clare, A. (1981) Changing patterns of psychiatric care. British Medical Journal, 282, 375–377.CrossRefGoogle ScholarPubMed
Wing, J., Bebbington, P. & Robins, L. (1981) What is a Case? The Problem of Definition in Psychiatric Community Surveys. London: Grant McIntyre.Google Scholar
World Health Organisation (1973) Psychiatry and Primary Medical Care. Report of a Working Group. Copenhagen: WHO Regional Office for Europe.Google Scholar
World Health Organisation (1980) Changing Patterns in Mental Health Care. Report of a Working Group. Copenhagen: WHO Regional Office for Europe.Google Scholar
World Health Organisation (1983) First Contact Mental Health Care. Report of a Working Group. Copenhagen: WHO Regional Office for Europe.Google Scholar
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