Liaison psychiatry in rural general practice

Area of Science:

• Health Services Research
• Primary Care Medicine
• Psychiatry

Background:

• Government health strategy identifies poor integration between primary and secondary care in Ireland.
• General Practitioners (GPs) are the primary point of contact for mental health disorders due to deinstitutionalization.
• Access to specialist psychiatric opinion is limited for most patients referred to psychiatric services.
• On-site psychiatric liaison to primary care is not common in Ireland, unlike in other countries.

Purpose of the Study:

• To explore the advantages of enhancing GPs' psychiatric skills.
• To investigate selective referral of more serious mental health disorders.
• To assess a model of integrated primary and secondary mental health care.

Main Methods:

• A model enhancing GPs' psychiatric skills and selective referral was adopted by GPs and psychiatrists in east Cavan.
• Focus on improving the integration of mental health care between primary and secondary services.

Main Results:

• Research suggests advantages for models that improve GPs' mental health skills.
• Selective referral of complex cases to specialist services is proposed.
• The adopted model in east Cavan serves as a potential blueprint for other settings.

Conclusions:

• Enhancing GPs' psychiatric skills and facilitating selective referrals can improve mental health care integration.
• This model is relevant given upcoming changes in primary care organization in Ireland.
• The east Cavan model offers a practical approach to addressing deficits in primary and secondary mental health care linkage.