Psychiatrists role in primary health care in Greece: findings from a quantitative study

Kyriakos Souliotis,Eirini Agapidaki,Chara Tzavara,Marina Economou

doi:10.1186/s13033-017-0172-0

Abstract

BackgroundAlthough the need for integration of mental health services into primary care is well established little has been done. The outbreak of the recession found the Greek mental health system in transition. As a response to the crisis, governments implemented horizontal budget cuts instead of health reforms. This resulted in an unfavorable situation for mental health which was set once again on the sidelines of the health policy agenda. Previous studies suggest that the most prevalent disorders in the years of financial crisis in Greece are depression and anxiety while a general increase of the psychiatric morbidity is observed does not follow the population’ needs.MethodsThe present descriptive study was carried out between March and June of 2015. A convenience sample of 174 psychiatrists and psychiatry residents who met the inclusion criteria were finally selected to participate. Data were collected by using a 40-items questionnaire consisted of three sections: (a) nine questions about demographics, (b) nine questions pertaining to general aspects of administrative regulations related to primary care, (c) 22 questions about psychiatrists attitudes and perceptions towards their role in primary care. Quantitative variables are expressed as mean values, while qualitative variables as absolute and relative frequencies.ResultsThe vast majority of participants perceives the public primary care services and mental health services in their community as inadequate and considers psychiatrists’ participation in primary care as important in order to improve the detection and management rates of people demonstrating mental health symptoms. They also believe that: (a) primary care practitioners’ usually fail to detect the mental health conditions of patients; (b) their participation in primary care will decrease the social stigmatization for mental health conditions; (c) patients receiving pharmaceutical treatment for mental health problems by GPs and other primary care professionals usually fail to comply.ConclusionsRespondents in the present study are receptive to participate in primary care. They believe that their inclusion to primary care will result to decreased social stigmatization for mental health problems, increased patient’ access and improved detection and management rates for common mental health conditions.

Highlights

The need for integration of mental health services into primary care is well established little has been done
Our results are in line with previous efforts in the field [40,41,42,43,44] and indicated that psychiatrists and psychiatric residents are receptive to participate in primary care important barriers were cited
Physicians in our study reported that the inclusion of psychiatrists in primary care will decrease the social stigmatization for mental health problems, increase population access to qualitative mental health services and improve the detection and management rates of patients with mental disorders

Summary

Introduction

The need for integration of mental health services into primary care is well established little has been done. Evidence suggests that almost half of patients, who seek for help in the context of primary care in European countries, remain undetected and untreated [10] while the number of in-patients with mental health disorders has been increased and climbed up to 3.5 million [11, 12]. This would be attributed mainly to the failure of early detection and effective management [8]. One of the main inhibitors at health policy level is that mental health in terms of strategic planning, public health expenditure and sustainability is not high on the agenda in many European countries [7, 22,23,24]

Methods

Results

Discussion

Conclusion