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Does Specializing in Family Medicine Improve the Detection and Diagnosis of Mental Health Problems?
Tzipi Hornik-Lurie1, Julie Cwikel2, Nelly Zilber3
1Social Work Department, Ben-Gurion University of the Negev, Beer Sheva, Israel The Falk Institute for Mental Health Studies, Kfar Shaul Hospital, Givat Shaul, Jerusalem, Israel.
Background:
Approximately half the patients seeking mental health (MH) treatment consult primary care practitioners (PCPs). Previous research indicates that patients often do not receive correct MH diagnoses or appropriate treatment from PCPs. The present study examines whether a specialization in family medicine compared to other or no PCP residency programs enhances physicians' ability to detect, diagnose and treat MH problems.
Methods:
Face-to-face interviews with 49 physicans in eight clinics in Israel. Two case vignettes and questionnaires assess MH awareness and factors influencing treatment.
Results:
Significantly more family practitioners (FPs) compared to others correctly diagnosed depression and anxiety vignettes were aware of patients' MH problems and prescribed psychotropic drugs.
Limitations:
Small sample size, indirect examination of PCPs' skills using vignettes and the absence of psychotherapy options.
Conclusions:
FPs are more likely than other PCPs to detect, diagnose and treat MH problems. To improve MH detection among a broad range of PCPs, an expanded MH curriculum should be encouraged. Additional MH training should be available for all PCPs.
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