What do Dublin GPs expect from a psychiatric referral?

Area of Science:

• Psychiatry
• General Practice
• Mental Health Services

Background:

• Community psychiatry models increasingly integrate primary and secondary care.
• Understanding the interface between general practice and specialist psychiatric services is crucial for effective patient management.
• General practitioners (GPs) play a pivotal role in initial mental health assessments and treatment.

Purpose of the Study:

• To investigate the pre-referral management of patients with psychological illness by general practitioners (GPs) in West Dublin.
• To analyze the reasons for referral from general practice to public psychiatric outpatient clinics.
• To understand GP expectations regarding psychiatric referrals and their role in ongoing patient care.

Main Methods:

• A postal questionnaire survey was administered to general practitioners.
• The study analyzed 70 new referrals to three West Dublin Psychiatric Sectors over a four-month period in 1991.
• Data collected included referral reasons and prior management within general practice.

Main Results:

• Patients averaged six GP visits over ten months before referral, with mixed anxiety/depression being the most common diagnosis (23%).
• Most patients received prior treatment, including 61% on medication and 67% receiving counseling.
• Key referral reasons included access to therapies (30%), treatment failure (20%), and shared chronic care (14%), with only 13% seeking full transfer of care.

Conclusions:

• General practitioners in the surveyed area provide substantial pre-referral management for psychological conditions.
• GPs have clear expectations for psychiatric referrals, often seeking collaborative care and specialized interventions.
• Future community psychiatric service planning should acknowledge and support the active role of GPs in managing mental health and their desire for follow-up care.