Managing mental illness in primary care - General Practitioners' perspective

Abstract

Background: The Agency for Integrated Care (AIC) conducted a survey to determine the specific areas in which the agency could work with General Practitioners (GPs) to enhance mental illness management in Singapore. This survey was conducted as part of AIC’s engagement strategy and because the Primary Care Surveys 2010 and 2005 noted that a sizeable number of mental health cases are seen by GPs. Methodology: An interviewer-administered questionnaire was conducted among a random sample of 849 group and non-group GPs practicing in four geographical districts of Singapore. The response rate was 64%. Findings: About 70% of the respondent GPs indicated that they were seeing patients with mental illness. Anxiety and depression were the most commonly seen mental conditions. The lack of available drugs and facilities in the clinic, and unfamiliarity with mental health patient management were the main reasons that GPs do not see patients with mental illness. About 39% of the GPs referred patients to a psychologist. About 36% of the GPs referred patients to a counsellor. Availability of additional allied health services in the neighbourhood was crucial in encouraging GPs to see more patients with mental illness. General geriatrics, dementia, general mental health and major depression were the top four areas of interest for further training. Conclusions: The role of GPs in managing mental illnesses remains crucial. There is more pressing need to address their perceived difficulties in managing such patients. The results of the GP Landscape Survey provided evidential bases to enhance the National Mental Health Blueprint in three areas: (i) extension of GP consultation subsidies to middle-income patients, (ii) expansion of allied mental health services to support GPs, and (iii) development of training programmes for GPs in mental illnesses that are commonly encountered by and of interest to GPs.