The Practice Nurse Mental Health in general practices: effects on diagnoses of alcohol abuse

Abstract

Background As part of health policy aiming to improve early detection and treatment of mental illness in general practices, from 2008 mental health practice nurses were gradually introduced in general practices in the Netherlands. The current study aims to investigate the effect of the introduction of the practice nurse mental health in general practices in the Netherlands on the number of diagnoses of chronic and acute alcohol abuse. Methods For this study, the Netherlands Institute for Health Services Research (NIVEL) retrieved data of a representative sample of general practices (n = 187). Practices that implemented a practice nurse mental health were centered on date of implementation. Differences in number of diagnoses of chronic and acute alcohol abuse between practices with a practice nurse mental health (with and without primary care psychologists) and control practices (practices without a practice nurse mental health and without primary care psychologists) were analyzed with multilevel regression analyses. Results Practices that implemented a practice nurse mental health and that have a primary care psychologist, diagnosed significantly more patients with chronic alcohol abuse 1 year as well as 2,5 years after implementation than control practices (s=-2.45, p < 0.05) and also significantly more patients with acute alcohol abuse 1,5 years after implementation (s=-.75, p < 0.05). No significant differences were found between practices that only have a practice nurse mental health and control practices. Conclusions The combination of a practice nurse mental health and primary care psychologists in general practices does lead to more diagnoses of alcohol abuse, possibly due to more manpower and multidisciplinary cooperation. The sole introduction of practice nurses mental health does not lead to more diagnoses of alcohol abuse. Key messages: •Practice nurses mental health are an important link between GPs and primary care psychologists in diagnosing alcohol abuse. •More manpower and multidisciplinary cooperation is beneficial. (aut. ref.)