GPs\u2019 and child and adolescent psychiatry specialists\u2019 experiences of joint consultations in the GP\u2019s office: a qualitative study

Tori Guldahl Seierstad,Ingun Toftemo,Ole Rikard Haavet,Mette Brekke

doi:10.1186/s13104-017-2766-7

Abstract

BackgroundThe study is an exploration of a joint consultation model, a collaboration between general practitioners (GPs) and specialists from child and adolescent mental health services (CAMHS) in Lillehammer, Norway.MethodsA qualitative study based on two focus group interviews, one with participating GPs and one with participating specialists from the local CAMHS. Participants were five GPs, with work experience varying from 6 months to 20 years (four of them specialists in general medicine) and two CAMHS specialists—a psychiatrist and a psychologist—both with more than 20 years of experience.ResultsThe focus group discussions revealed that both GPs and CAMHS specialists saw the joint consultations as a good teaching method for improving GPs’ skills in child and adolescent psychiatry. Both groups believed that this low-threshold service benefits the patients and that the joint consultation is especially suited to sort problems and determine the level of help required.ConclusionsThe GPs and CAMHS specialists shared the impression that the collaboration model is beneficial for both patients and health care providers. Close collaboration with primary health care is recommended in the guidelines for child and adolescent psychiatry outpatient clinics. We suggest that the joint consultation model could be a good way for GPs and CAMHS specialists to collaborate.

Highlights

The study is an exploration of a joint consultation model, a collaboration between general practitioners (GPs) and specialists from child and adolescent mental health services (CAMHS) in Lillehammer, Norway
Hafting has shown that an interested GP is in a good position to provide services to children and adolescents with mental health problems, but that many GPs believe that they lack specific knowledge in child and adolescent psychiatry [1]
We have found joint consultations with GPs described in adult psychiatry [34,35,36] and in paediatrics [16, 17], but we have found no studies that describe joint consultation in a general practice with child and adolescent psychiatry specialists

Summary

Introduction

The study is an exploration of a joint consultation model, a collaboration between general practitioners (GPs) and specialists from child and adolescent mental health services (CAMHS) in Lillehammer, Norway. GPs do have a role in child and adolescent mental health care [1,2,3,4] It is, shown that GPs’ skills in child and adolescent psychiatry could be improved [1, 3, 5,6,7,8,9,10,11]. Zwaanswijk found that approximately 80% of children and adolescents with psychological problems had seen their GP within the preceding year, but GPs’ identification of psychological problems was limited [6] These findings are consistent with other studies [5, 12]. A Cochrane review examining interventions to change outpatient referral rates or improve outpatient referral appropriateness found that active local educational interventions involving secondary care specialists and structured referral sheets are the only interventions that lower referral rates, based on current evidence [22]

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