Sharing Psychiatric Care with Primary Care Physicians: The Toronto Doctors Hospital Experience (1991

Abstract

French

Objectives:

To investigate the shared mental health care experience of the psychiatry department of a small urban general hospital, which serves an ethnoculturally diverse population.

Methods:

A chart survey was undertaken of all patients referred by community physicians to a new shared care program between January 1991 and December 1995. Selected demographic and diagnostic characteristics were collected and analyzed.

Results:

Seven hundred and thirteen patients were assessed. They were principally female, ethnoculturally varied, and highly comorbid. The most striking association involved mood and substance-related disorders.

Conclusion:

The Doctors Hospital experience shows that the shared care approach can reach large numbers of patients through a multiplier effect. Additionally, this approach has the potential to enhance access for ethnoculturally varied and diagnostically complex groups.

Keywords

primary care psychiatry transcultural psychiatry community psychiatry

References

Lin

Goering

Offord

Campbell

Boyle

. The use of mental health services in Ontario: Epidemiologic findings. Can J Psychiatry 1996;41:572–7.

Kates

Craven

Bishop

Clinton

Kraftcheck

LeClair

, and others. Shared mental health care in Canada. Ottawa (ON): Canadian Psychiatric Association [CPA] and The College of Family Physicians of Canada; October 1997. Position paper nr 1997–38. 12 p. Available from: CPA, 260–441 MacLaren Street, Ottawa, ON K2P 2H3.

Dubois

Nugent

Broder

Psychiatric consultation with children in under serviced areas: Lessons from experiences in northern Ontario. Can J Psychiatry 1991;36:456–61.

Kates

Lesser

Dawson

Devine

Wakefield

Psychiatry and family medicine: The McMaster approach. Can J Psychiatry 1987;32:170–4.

Nickels

McIntyre

A model for psychiatric services in primary care settings. Psychiatr Serv 1996;47:522–6.

Strathdee

Primary care–psychiatry interaction: A British perspective. Gen Hosp Psychiatry 1987;9:102–10.

Menninger

Psychiatric experience in the war, 1941–1946. Am J Psychiatry 1947;March:584.

Hausman

Military psychiatry. A prototype of social and preventative psychiatry in the United States. Arch Gen Psychiatry 1967;16:727–39.

Talbott

Community psychiatry in the army. JAMA 1969;210:1233–7.

10.

Lipowski

Current trends in consultation–liaison psychiatry. Can J Psychiatry 1983;28:329–38.

11.

Kessler

McGonagle

, and others. Lifetime and 12–month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the natural comorbidy survey. Arch Gen Psychiatry 1994;51:8–19.

Sharing Psychiatric Care with Primary Care Physicians: The Toronto Doctors Hospital Experience (1991–1995)