Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-19T13:16:23.678Z Has data issue: false hasContentIssue false
  • English
  • Français

Integration between primary and secondary services in the care of the severely mentally ill: patients' and general practitioners' views

Published online by Cambridge University Press:  03 January 2018

Jonathan Bindman ,
Sonia Johnson ,
Steve Wright ,
George Szmukler ,
Paul Bebbington ,
Elizabeth Kuipers  and
Graham Thornicroft
Jonathan Bindman*
Affiliation:
Maudsley Continuing Care Study, Institute of Psychiatry, London
Sonia Johnson
Affiliation:
Maudsley Continuing Care Study, Institute of Psychiatry, London
Steve Wright
Affiliation:
Maudsley Continuing Care Study, Institute of Psychiatry, London
George Szmukler
Affiliation:
Bethlem and Maudsley NHS Trust
Paul Bebbington
Affiliation:
Social and Epidemiology Psychiatry Unit, Institute of Psychiatry
Elizabeth Kuipers
Affiliation:
Department of Psychology, Institute of Psychiatry
Graham Thornicroft
Affiliation:
Institute of Psychiatry, London
*
Dr J. Bindman, Maudsley Continuing Care Study, Institute of Psychiatry, De Crespigny Park. London SE5 8AF. Fax: (0171) 277 1462
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Communication between secondary and primary care is an important aspect of continuity of care. We investigated communication between general practitioners (GPs) and psychiatric teams about a representative group of patients with severe mental illness (SMI). We also sought views on GP involvement in care from the patients and their GPs.

Methods

One hundred patients with SMI were randomly selected from those under the care of two psychiatric sector teams in inner London. The patients and their GPs were interviewed.

Results

GPs' knowledge about the care their patients received was limited. Most GPs perceived their role as providing physical care and prescribing. Few patients consulted GPs for mental health care. GPs perceived themselves as less involved in the care of Black Caribbean or Black African patients.

Conclusions

Considerable discontinuities of care between secondary and primary care were identified. GP involvement in the care of patients with SMI appears limited. Better communication is necessary if care is to be shared.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 169 - 174
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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

REFERENCES

Butler, R. & Greenberg, M. (1994) The ‘new model’ discharge summary: is it working? Psychiatric Bulletin, 18, 555–556.Google Scholar
Corney, R. & Strathdee, G. (1996) Women and primary care. In Planning Mental Health Services for Women. A Multiprofessional Handbook, (eds K. Abel, M. Buszewicz, S. Davison, et al), pp 191–201. London: Routledge.Google Scholar
Coulter, A. (1995) General practice fundholding: time for a cool appraisal. British Journal of General Practice, 45, 119–120.Google Scholar
Davies, S., Thornicroft, G., Leese, M., et al (1996) Ethnic differences in risk of compulsory admission among representative cases of psychosis in London. British Medical Journal, 312, 533–537.Google Scholar
Department of Health (1995) Building Bridges: A Guide to Arrangements for Inter-Agency Working for the Care and Protection of Severely Mentally III People. London: Department of Health.Google Scholar
Essex, B., Doig, R. & Renshaw, J. (1990) Pilot study of records of shared care for people with mental illness. British Medical Journal, 300, 1442–1446.Google Scholar
General Medical Services Committee (1996) Mentally Disordered People: Continuing Care in the Community. Guidance for GPs. London: British Medical Association.Google Scholar
Goldberg, D. & Jackson, G. (1992) Interface between primary care and specialist mental health care. British Journal of General Practice, 42, 267–269.Google ScholarPubMed
Grace, J., Steels, M. & Baruah, R. (1996) General practitioners' knowledge of and views on the care programme approach. Psychiatric Bulletin, 20, 643–644.Google Scholar
Kendrick, T., Sibbald, B., Burns, T., et al (1991) Role of general practitioners in care of long term mentally ill patients. British Medical Journal, 302, 508–510.CrossRefGoogle ScholarPubMed
Kendrick, T., Burns, T. & Freeling, P. (1995) Randomised controlled trial of teaching general practitioners to carry out structured assessments of their long term mentally ill patients. British Medical Journal, 311, 93–98.Google Scholar
King, M. (1992) Management of patients with schizophrenia in general practice. British Journal of General Practice, 42, 310–311.Google Scholar
Littlewood, R. & Lipsedge, M. (1982) Aliens and Alienists: Ethnic Minorities and Psychiatry. London: Penguin.Google Scholar
London, M. (1986) Mental illness among immigrant minorities in the United Kingdom. British Journal of Psychiatry, 149, 265–273.Google Scholar
Nazareth, I., King, M., Haines, A., et al (1993) Care of schizophrenia in general practice. British Medical Journal, 307, 910.Google Scholar
Nazareth, I., King, M. & Davies, S. (1995) Care of schizophrenia in general practice: the general practioner and the patient. British Journal of General Practice, 45, 343–347.Google Scholar
Norusis, M. J. (1993) SPSS for Windows. Base System Users' Guide. Release 6.0. Chicago, IL: SPSS.Google Scholar
Pullen, I. & Yellowlees, A. J. (1985) Is communication improving between general practitioners and psychiatrists? British Medical Journal, 290, 31–33.Google Scholar
Ritchie, J. H. (1994) The Report of the Inquiry into the Care and Treatment of Christopher Clunis. London: HMSO.Google Scholar
Royal College of General Practitioners (1993) Report of a joint College working group. Shared Care of Patients with Mental Health Problems (Occasional paper 60). London: Royal College of General Practitioners.Google Scholar
Wilkinson, G. (1991) The role of primary care physicians in the treatment of patients with long term mental disorders. International Review of Psychiatry, 3, 35–42.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.