[General practitioner and mental diseases among children and adolescents]

Child and adolescent psychiatry in primary health care is scarcely investigated. The purpose of this article is to describe some aspects of the role of the general practitioner in the care of young patients with psychiatric problems.

Data were collected from four focus group interviews with 19 general practitioners. The material was analysed in a phenomenological perspective. The aim was to develop new and documented descriptions seen from the participants' point of view, interpreted within the framework of available knowledge about care for children and adolescents with psychiatric problems.

The general practitioner is in a good position to provide psychiatric care for these patients because of his or her unique knowledge about the families and the local communities. They have their patients' confidence and acquired skills from their unselected practice to recognise serious and abnormal conditions. The majority of the informants did not feel sufficiently skilled in order to treat more specific child and adolescent psychiatric disorders. Some informants were actively involved in multidisciplinary networks concerning their young patients, while others were neither involved nor informed about it. In addition, local health and welfare services to a lesser extent involved these doctors. Because of this, children and adolescents who might have been assessed and treated in primary health care could be referred directly to specialists. A need for guidance and updating on relevant knowledge from the specialist health care was expressed. From the results we might assume that specialists might give some general practitioners the professional security needed in order to take on the role of medical co-coordinator of the multidisciplinary services to young patients with mental health problems.