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Counselling in Primary Care – A General Practitioner’s Perspective

M Rafferty1, C Bradley2

  • 1Mercy University Hospital, Co. Cork

Irish Medical Journal
|March 21, 2019
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Summary

General Practitioners (GPs) found Counselling in Primary Care (CIPC) beneficial for treating mild to moderate mental health issues. They suggested expanding the service and noted positive patient outcomes, reducing psychiatric referrals.

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Area of Science:

  • Primary Care Medicine
  • Mental Health Services Research
  • Qualitative Health Research

Background:

  • The Health Service Executive (HSE) introduced Counselling in Primary Care (CIPC) in 2013.
  • CIPC offers short-term counselling for mild to moderate mental health problems in medical card holders.
  • General Practitioners (GPs) are key gatekeepers to mental health services in primary care.

Purpose of the Study:

  • To explore GPs' perspectives on the utility and impact of the CIPC service.
  • To identify potential areas for service improvement from the GP viewpoint.

Main Methods:

  • Qualitative study employing semi-structured interviews with GPs in the Cork/Kerry region.
  • Purposeful sampling of 40 GPs based on location, gender, practice size, and years qualified.
  • Framework analysis of verbatim interview transcripts from 19 participating GPs.

Main Results:

  • GPs unanimously affirmed the benefit of CIPC for mild to moderate mental health disorders.
  • Key suggestions for improvement included extending eligibility to GP visit card holders and adolescents aged 16-18.
  • A majority of GPs (n=12) indicated that a combined approach of talk therapy and medication yields the best patient outcomes.

Conclusions:

  • CIPC demonstrates potential to enhance primary care mental health services.
  • GPs report positive patient outcomes and a decrease in psychiatric referrals for appropriately managed cases.
  • Service enhancements, such as expanded eligibility, could further optimize CIPC's contribution to community mental healthcare.