Preparedness of Lithuanian general practitioners to provide mental healthcare services: a cross-sectional survey.

Lina Jaruseviciene,Gediminas Jarusevicius,Skirmante Sauliune,Jeffrey Victor Lazarus

doi:10.1186/1752-4458-8-11

Abstract

BackgroundA large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners’ (GPs) experience in mental healthcare and their perceptions about how to increase their involvement in the field.MethodsIn this cross-sectional study, a 41-item questionnaire was distributed to a random sample of 797 Lithuanian GPs in order to investigate current practices in their provision of mental healthcare as well as their suggestions for the improvement of mental healthcare services in primary care.ResultsThe response rate was 52.2%. Three-quarters of the GPs agreed that they feel responsible for the management of mental health problems, but only 8.8% of them agreed that “My knowledge in mental healthcare is sufficient”. Psychiatrists were identified as the mental healthcare team specialists with whom 32% of the respondents discuss the management of their patients with a mental disorder. Collaboration with psychologists and social workers was almost threefold lower (11.6% and 12.5%). Capacity-building of GPs was found to be among the most promising initiatives to improve mental health services in primary care. Other strategies mentioned were policy level and managerial measures as well as strengthening the teamwork approach in mental healthcare.ConclusionsThis study found a low self-reported competence of GPs in mental healthcare and low collaboration among GPs and other specialists in providing mental healthcare. For the situation to improve in the country, these findings point to a need for strategies to improve GPs’ expertise and teamwork in mental healthcare.

Highlights

In many settings, the burden of mental disorders is increasing while stigma associated with these disorders coupled with insufficient specialized human resources continues
general practitioners’ (GPs) feel responsible for their mentally ill patients and consider themselves to be part of the care system for these patients [9], surveys performed in Australia in 1997 and 2007, for example, demonstrate that this does not necessarily enable them to meet patients’ needs: the surveys jointly documented an overall rise in the use of mental healthcare services, the proportion of the population accessing mental healthcare from GPs remained unchanged [10]
The focus groups discussions addressed several issues related to mental healthcare provision: collaboration practice in providing mental healthcare services, difficulties faced by GPs in providing mental health services for their patients and the potential seen by GPs to increase their involvement in mental healthcare

Summary

Introduction

The burden of mental disorders is increasing while stigma associated with these disorders coupled with insufficient specialized human resources continues. This situation calls for the development of new models for meeting mental healthcare needs [1]. The Lithuanian Mental Health Strategy (2007) has underlined the pivotal role of general practitioners (GPs) in the provision of mental healthcare [2]. A large unmet need for mental healthcare [7] is partially attributable to a lack of primary care providers with mental healthcare skills [8]. A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners’ (GPs) experience in mental healthcare and their perceptions about how to increase their involvement in the field

Objectives

Methods

Results

Discussion

Conclusion