Models of mental health nurse-general practitioner liaison: promoting continuity of care.

Abstract

AIM AND RATIONALE: Community mental health nurses and general practitioners share a pivotal role in the provision of mental health care in the community. The focus of this study was to identify models of general practitioner collaboration used by these nurses, and analyse the implications of these models for promoting continuity of care. The study was derived from a larger study of how community mental health nurses promote wellness with clients who are experiencing an early episode of psychotic illness. This qualitative study used interviews and observation to collect data. The study took place in 1999 in regional and rural New South Wales, Australia and involved community mental health nurses. The findings show that two models of nurse and general practitioner (GP) collaboration emerged from the data: Shared Care and Specialist Liaison. In the Shared Care model, nurses maintain close contact with GPs throughout the episode of acute care. In the Specialist Liaison model, the community mental health team assumes overall responsibility for care and treatment throughout the acute episode of illness. Contact with GPs throughout the episode of care by the community mental health team is, at best, intermittent. The findings suggest that the Shared Care model is more consistent with supporting personal and organizational continuity of care, whereas the Specialist Liaison model is limited to encouraging personal continuity of care but further study is needed.