AS35-02 - The collaboration of cl-psychiatry and primary care medicine in Portugal

Abstract

Collaboration between primary care and mental health services has positively progressed in the last ten years in Portugal. The 2007 National Mental Health Plan, emphasizing the community intervention model, has promoted closer articulation between both services. Progressively a greater number of mental health services have adopted the new model and developed since some kind of collaboration with primary care services in their catchment area. In this context, the two affiliated departments of psychiatry of the New University of Lisbon developed different models of a close collaboration between the mental health teams and primary care centers. To give a general overview of the main characteristics and an analysis of the first results of mental health and primary care collaboration in these two departments. Each affiliated department of psychiatry carried out a specific model of articulation: in one case, common and severe mental disorders are managed by separate mental health teams, while in the other they are managed by the same teams, using rules for referral of patients to mental health, articulation of interventions and back referral to general practitioners, and triage on the urgency of the referrals. Regular meetings to discuss cases and training takes place in both models. The pros and cons of the two models of collaboration will be presented and discussed. However, shortage of general practitioners and their reorganization in new family health units have added difficulties to the collaboration with mental health services, stressing the need for new possible models.