Attitudes of general hospital consultants towards psychosocial and psychiatric problems in Netherlands

Psychosocial and psychiatric problems are common in patients admitted to general hospitals, and can negatively influence course of somatic diseases. Hence, early identification and adequate management is important. The aim of this study is to investigate attitudes towards psychosocial and psychiatric problems by non-psychiatrist consultants in an academic hospital. Data were collected by anonymous, self- administered questionnaires which were provided to all consultants during morning reports and by email. Of 431 eligible participants, 187(43%) completed the questionnaire: 64% during morning reports, and 36% by email. Almost all consultants report generally positive attitudes towards mental health problems. However, we identified several obstacles towards management. First, there was a discrepancy between positive attitude and the willingness to take on management responsibility. Reported reasons for this discrepancy were time constraints and lack of skills. We also found that consultants feel little responsibility for the management of depression and chronic drinking. Physicians have generally more positive attitudes than surgeons. Finally, all consultants are less likely to refer patients with dementia and treatment non-compliance to psychiatry, for reasons of perceived ineffectiveness and fear of stigmatizing patients. We conclude targeted education on the management of these problems for hospital consultants is still warranted.