TITLE:
Interprofessional Communication and Relationships in the Management of “Difficult to Treat” Depression: Perceptions of the Role of General Practitioners
AUTHORS:
Kay M. Jones, Leon Piterman
KEYWORDS:
Depression, Perceptions, Psychiatry
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.5 No.3,
June
4,
2015
ABSTRACT: Background: Team based
care is an essential ingredient of chronic disease management including chronic
mental illness. Effective health care teams include members who have defined,
yet intersecting roles, where mutual respect characterises professional
interaction and the patient’s well-being is central. The aim was to explore the
perception of psychologists, psychiatry registrars and psychiatrists with
respect to GPs’ role in managing difficult-to-treat-depression (DTTD). Methods:
A previously developed semi-structured interview schedule comprising six
questions was used. Thirty-two health professionals participated. Data were
analysed using the Framework method. Findings: Four main themes emerged: 1) The team approach was important,
particularly to ensure information accuracy and/or when responding to patient
needs and pressures; 2) Referrals, usually generated by GPs can be a vehicle
for other health professionals to provide advice to the GP; 3) Availability and
accessibility often depended on health professionals work location and knowing
how to navigate the system; 4) Limited availability of government funding
impacts on patients’ accessibility to health professionals. Discussion:
Interprofessional relationships were described as paramount. Appropriate and
timely referrals are integral to patient management, regardless of challenges.
Ongoing challenges include program funding, workforce numbers and costs to
patients. Improvement to mental health care access was noted, even for patients
among relatively disadvantaged groups and those receiving Medicare Benefits
Schedule-subsidised services. Conclusion: Despite adequate GP/specialist
communication, the delivery of optimal team based care to patients with
difficult-to-treat depression is compromised by lack of access to specialised
services and inadequate funding.