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The work of primary care physicians in mental health following the mental health care reform
Researchers: Yael Ashkenazi1, Hava Tabenkin2
- Myers-JDC-Brookdale Institute
- Formerly Clalit Health Services
Background: Primary care physicians play an important role in the initial identification and treatment of patients with mental-health (MH) problems. This role bears examining, particularly in light of the transfer of MH services to the responsibility of the health plans.
Objectives: To examine and describe the MH-related work of primary care physicians, their interface with MH professionals, and the reform's impact on the former.
Method: A qualitative study using semi-structured, in-depth interviews, mainly with 39 primary care physicians.
Findings: Family physicians treat a large portion of patients with "soft" psychiatric problems themselves; for patients with more severe MH problems, they conduct follow-up and encourage continuity of treatment.
Pediatricians intervene with, and treat, children mainly for problems where they can be helpful by instructing parents or making referrals.
Following the MH reform, the health plans developed communication and consultation channels between primary physicians and MH professionals. In practice, the physicians are not always aware of these channels and, if they are, they do not always find them satisfactory.
In most cases, the physicians feel that the reform has not affected their work significantly.
Pediatricians intervene with, and treat, children mainly for problems where they can be helpful by instructing parents or making referrals.
Following the MH reform, the health plans developed communication and consultation channels between primary physicians and MH professionals. In practice, the physicians are not always aware of these channels and, if they are, they do not always find them satisfactory.
In most cases, the physicians feel that the reform has not affected their work significantly.
Conclusions: Primary physicians regard MH as part of their work with intervention in treatment varying according to type of problem, and for adults and children.
The communication and interface between primary medicine and MH services require improvement. Technicalities aside, thought should be devoted to such questions as desirable models of cooperation and mutual help between the various areas for the benefit of treatment.
The communication and interface between primary medicine and MH services require improvement. Technicalities aside, thought should be devoted to such questions as desirable models of cooperation and mutual help between the various areas for the benefit of treatment.
Recommendations: Reinforcement of relations between MH services and primary medicine: communication channels, information exchange, models of co-working.
Addition of MH topics to pediatric training.
Development of communication channels between pediatricians and other systems caring for children (education, social services).
Addition of MH topics to pediatric training.
Development of communication channels between pediatricians and other systems caring for children (education, social services).
Research number: R/63/2015
Research end date: 12/2017