Skip to main content Accessibility help
×
×
Home

Psychiatrists in Primary Health Care Settings

  • Alexander R. K. Mitchell (a1)

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.

Copyright

References

Hide All
Balint, M. (1957) The Doctor, His Patient and The Illness. London: Pitmans.
Brandon, S. (1970) Crisis theory and the possibility of therapeutic intervention. British Journal of Psychiatry, 117, 627633.
Brook, A. (1967) An experiment in general practitioner-psychiatrist cooperation. Journal of the Royal College of General Practitioners, 13, 127131.
Brook, A. & Temperley, J. (1976) The contribution of a psychotherapist to general practice. Journal of the Royal College of General Practitioners, 28, 8694.
Brook, P. & Cooper, B. (1975) Community mental health care: primary team and specialist services. Journal of the Royal College of General Practitioners, 25, 93110.
Browne, K. & Freeling, P. (1967) The Doctor–Patient Relationship. Edinburgh and London: Livingstone.
Caplan, G. (1970) The Theory and Practice of Mental Health Consultation. London: Tavistock Publications.
Carse, J., Panton, N. & Watt, A. (1958) A district mental health service: the Worthing experiment. Lancet, i, 3941.
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.
Clare, A. & Lader, M. (1982) Psychiatry and General Practice. London: Academic Press.
Clare, A. (1983) Psychiatry in general practice. Journal of the Royal College of General Practitioners, 33, 195198.
Cooper, J. (1982) Psychiatrists and Primary Care in Nottingham. In Psychiatry and General Practice (eds Clare, A. & Lader, M.). London: Academic Press.
Corney, R. (1982) Social work in general practice. In Psychiatry and General Practice. London: Academic Press.
Corser, C. & Ryce, S. (1977) Community mental health care: a model based on the primary care team. British Medical Journal, 11, 936938.
De Alarcon, R., De Glanville, H. & Hodson, J. (1960) Value of the specialist's report. British Medical Journal, 11, 16631664.
De Alarcon, R., & Hodson, J. (1964) Value of the general practitioner's letter. British Medical Journal, 11, 435438.
Farewell, T. (1976) Crisis intervention. Nursing Mirror, 142, 6061.
France, R. & Robson, M. (1982) Work of the clinical psychologist in general practice: preliminary communication. Journal of the Royal Society of Medicine, 75, 185189.
Fry, J. (1984) “Screening”, paper presented at conference on “Mental Illness in Primary Care Settings”. Institute of Psychiatry, London, 17–18 July.
Gersons, B. (1984) The consultation relationship between psychiatry and general practice. World Psychiatric Association Symposium, Helsinki, Finland, June.
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, 12871289.
Goldberg, D. (1983) Reported in Hospital Doctor, 10 November, page 11.
Goldberg, D. & Blackwell, B. (1970) Psychiatric illness in general practice; a detailed study using a new method of case identification. British Medical Journal, 11, 439443.
Goldberg, D. Kay, C. & Thompson, L. (1976) Psychiatric morbidity in general practice and the community. Psychological Medicine, 6, 565569.
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community—The Pathway to Care. London: Tavistock Publications.
Gray, A. (1982) Tools for decision making. Health and Social Services Journal, 11 February, 184186.
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, 231241.
Harker, P., Leopoldt, H. & Robinson, J. (1976) Attaching community psychiatric nurses to general practice. Journal of the Royal College of General Practitioners, 26, 666671.
Higgs, R. (1984) Life changes. British Medical Journal, 288, 15561557.
Horder, J. (1984) Professional Team Roles. Paper presented at conference on Mental Illness in Primary Care Settings, Institute of Psychiatry, London, 17–18 July.
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, 15071511.
Howie, J. (1979) Research in General Practice. London: Croom Helm.
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, 7883.
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, 185191.
Johnstone, A. & Goldberg, D. (1976) Psychiatric screening in general practice; a controlled trial. Lancet, 5, 605608.
Kaeser, A. & Cooper, B. (1971) The psychiatric patient, the general practitioner, and the outpatient clinic: an operational study and a review. Psychological Medicine, I, 312325.
Kessel, N. (1960). Psychiatric morbidity in a London general practice. British Journal of Preventative and Social Medicine, 14, 1622.
Kessel, N. (1963) Who ought to see a psychiatrist? Lancet, i, 3941.
Langsley, D. (1982) Primary care and psychiatry. Social Psychiatry, 17, 8994.
Lyons, H. (1969) Joint psychiatric consultations. Journal of the Royal College of General Practitioners, 18, 125127.
Marinker, M. (1983) Should general practice be represented in the university medical school? British Medical Journal, 286, 855859.
Mcintosh, M. (1982) The clinical psychologist in practice. Psychiatry in Practice, I, (No. 9), 3841.
Mckechnie, A., Philip, A. & Ramage, J. (1981) Psychiatric services in primary care: specialised or not: Journal of the Royal College of General Practitioners, 31, 611614.
Mitchell, R. (1983a) Liaison Psychiatry in general practice. British Journal of Hospital Medicine, 30, 100106.
Mitchell, R. (1983b) Psychiatrists and general practitioners; working together. Psychiatry in Practice, 2, (No. 17), 1519.
Mitchell, R. (1983c) Psychiatrists and general practitioners: the dynamics of the referral. Psychiatry in Practice, 2, (No. 18), 1319.
Mitchell, R. (1984a) A psychiatrist in the health centre. Update (Journal of Postgraduate General Practice), 28(10), 11921196.
Mitchell, R. (1984b) Psychiatrists and general practitioners: the tri-partite interview. Psychiatry in Practice, 3, (No. 23), 2022.
Morrice, K. (1976) Crisis Intervention: Studies in Community Care. London: Pergamon.
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.
Oxman, T. & Smith, R. (1980) Consultation-liaison psychiatry within a family practice. Social Psychiatry, 17, 101107.
Rawnsley, K. & Loudon, J. (1962) Factors influencing referral of patients to a psychiatrist by general practitioners. British Journal of Preventative and Social Medicine, 16, 174182.
Robson, M., France, R. & Bland, M. (1984) Clinical psychologists in primary care: controlled clinical and economic evaluation. British Medical Journal, 288, 18051808.
Rodger, W. (1973) Community psychiatry in the health care: a Devon development. The Practitioner, 210, 799802.
Schniewind, H. (1977) A psychiatrist's experience in a primary health care setting. International Journal of Psychiatry in Medicine, 7, 229240.
Shepherd, M., Cooper, B., Brown, A. & Kalton, G. (1966) Psychiatric Illness in General Practice. London: Oxford University Press.
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.
Sladden, S. (1979) Psychiatric Nursing in the Community: A Study of a Working Situation. Edinburgh: Churchill Livingstone.
Spector, J. (1984) Clinical psychology and primary care: some dilemmas. Bulletin of the British Psychological Society, 37, 7376.
Spitzer, R. & Fleiss, J. (1974) A re-analysis of the validity of psychiatric diagnosis. British Journal of Psychiatry, 125, 341347.
Strathdee, G. (1984) “Patterns of collaboration”, paper presented at conference on “Mental Illness in Primary Care Settings”, Institute of Psychiatry, London, 17–18 July.
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, 615618.
Tait, D. (1983) Shared care between psychiatry and general practice. Update (Journal of Postgraduate General Practice), 26(2), 177184.
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, 400406.
Tyrer, P. (1984) Psychiatric Clinics in general practice: an extension of community care. British Journal of Psychiatry, 145, 914.
Tyrer, P. Seivewright, N. & Wollerton, S. (1984) General practice psychiatric clinics: impact on psychiatric services. British Journal of Psychiatry, 145, 1519.
Watts, C. (1966) Depressive Disorders in the Community. Bristol: Wright.
Williams, P. (1979) The interface between psychiatry and general practice. Smith, Kline A French Publications, 2, (No. 7).
Williams, P. & Clare, A. (1981) Changing patterns of psychiatric care. British Medical Journal, 282, 375377.
Wing, J., Bebbington, P. & Robins, L. (1981) What is a Case? The Problem of Definition in Psychiatric Community Surveys. London: Grant McIntyre.
World Health Organisation (1973) Psychiatry and Primary Medical Care. Report of a Working Group. Copenhagen: WHO Regional Office for Europe.
World Health Organisation (1980) Changing Patterns in Mental Health Care. Report of a Working Group. Copenhagen: WHO Regional Office for Europe.
World Health Organisation (1983) First Contact Mental Health Care. Report of a Working Group. Copenhagen: WHO Regional Office for Europe.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Psychiatrists in Primary Health Care Settings

  • Alexander R. K. Mitchell (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *