Financial incentives and disincentives for providing mental health care in general practice - a survey of nine European countries

The mental health of the elderly is a matter of increased concern in the context of an aging population since currently only a small fraction of this population is receiving adequate care. The provision of treatment in primary care by the General Practitioners (GPs) has been proposed for over a decade as a potential solution, as services offered by GPs are more accessible, less susceptible to stigma, and have a more comprehensive view of the other health care problems that the elderly might suffer from. In this study, we explored the perception of Romanian GPs regarding their practice and roles in caring for the mental health of the elderly as well as the willingness to increase their future involvement in the management of dementia and other mental health problems. Data was collected via an online questionnaire structured on four dimensions: (1) GPs' sociodemographic profile and practice characteristics, (2) GPs assessment of the services available for elderly with mental health problems, (3) GPs current involvement in mental health care for different categories of problems, and (4) factors that might influence the future involvement of GPs in providing care for elderly with mental health problems. The survey was sent via the member mailing lists of the National Society for Family Medicine. Results show that GPs are currently limited by prescribing possibilities, available resources and knowledge in the area, but they are willing to expand their role in the areas of early recognition and prevention of mental health problems as well as providing disease management and collaborative care. An improved communication with mental health care professionals, a better access to resources and having more financial incentives are the three most important categories for GPs to increase their involvement. In conclusion, increasing the access to personal and professional resources and setting up functional communication channels with specialized mental health care could motivate GPs to provide timely mental health support to elderly patients.

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Availability and accessibility of primary mental health services for adolescents: an overview of national recommendations and services in EU

European Journal of Public Health ◽

10.1093/eurpub/ckaa102 ◽

2020 ◽

Vol 30 (6) ◽

pp. 1127-1133

Author(s):

Pierre-André Michaud ◽

Annemieke Visser ◽

Johanna P M Vervoort ◽

Paul Kocken ◽

Sijmen A Reijneveld ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Services ◽

Health Services ◽

Mental Health Care ◽

Mental Health Problems ◽

European Countries ◽

Future Health ◽

Horizon 2020 ◽

Primary Mental Health Care

Abstract Background Mental health problems in adolescence can profoundly jeopardize adolescent current and future health and functioning. We aimed to describe existing recommendations and services regarding the delivery of primary mental health care for adolescents in 31 European countries. Methods Data on the availability and accessibility of primary mental health services were collected, as part of the Horizon 2020-funded project Models of Child Health Appraised. One expert from each country answered a closed items questionnaire during years 2017–18. Results All 31 participating countries had some policy or recommendations regarding the availability and accessibility of primary mental health services for adolescents, but their focus and implementation varied largely between and within countries. Only half of the participating countries had recommendations on screening adolescents for mental health issues and burdens. Merely a quarter of the countries had ambulatory facilities targeting specifically adolescents throughout the whole country. Just over half had some kind of suicide prevention programs. Same-day access to primary care in case of -health emergencies was possible in 21 countries, but often not throughout the whole country. Nineteen countries had strategies securing accessible mental health care for vulnerable adolescents. Conclusions Overall, around half of European countries had strategies securing access to various primary mental health care for adolescents. They frequently did not guarantee care over the whole country and often tackled a limited number of situations. EU countries should widen the range of policies and recommendations governing the delivery of mental health care to adolescents and monitor their implementation.

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Primary mental health care: The role for the general practice divisions program

Australian & New Zealand Journal of Psychiatry ◽

10.1080/000486700734 ◽

2000 ◽

Vol 34 (s1) ◽

pp. A54-A54

Keyword(s):

Mental Health ◽

Health Care ◽

General Practice ◽

Mental Health Care ◽

Primary Mental Health Care

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New Zealand general practice nurses' roles in mental health care

International Nursing Review ◽

10.1111/j.1466-7657.2010.00859.x ◽

2011 ◽

Vol 58 (2) ◽

pp. 225-233 ◽

Cited By ~ 6

Author(s):

E. McKinlay ◽

S. Garrett ◽

L. McBain ◽

T. Dowell ◽

S. Collings ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

General Practice ◽

New Zealand ◽

Mental Health Care ◽

Practice Nurses

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Better access to psychology services in primary mental health care: an evaluation

Australian Health Review ◽

10.1071/ah060195 ◽

2006 ◽

Vol 30 (2) ◽

pp. 195 ◽

Cited By ~ 6

Author(s):

Sanjyot Vagholkar ◽

Lesley Hare ◽

Iqbal Hasan ◽

Nicholas Zwar ◽

David Perkins

Keyword(s):

Mental Health ◽

Health Care ◽

General Practice ◽

Mental Health Care ◽

Patient Outcomes ◽

New South ◽

Psychological Services ◽

South Wales ◽

The University ◽

Program Data

Introduction: The Access to Allied Psychological Services program was introduced as part of the Better Outcomes in Mental Health Care initiative in 2001?2002. Divisions of General Practice are funded to establish programs that allow GPs to refer patients for psychological treatments. The University of New South Wales evaluated programs run by the Southern Highlands and Illawarra Divisions of General Practice. This paper presents the findings of these evaluations. Method: Both evaluations analysed process and patient outcomes. This was obtained from a combination of program data and qualitative satisfaction data. Results: The two program models differed in the mechanism of retention of the psychologists and the method of referral of patients. Anxiety and depression were the main reasons for referral, and clinical data showed there was improvement in patient outcomes. Patients, GPs and psychologists expressed satisfaction with the programs. Discussion: The Access to Allied Psychological Services programs in both Divisions have proven popular. Flexibility in the program structure allows Divisions to develop a model which suits their local circumstances. There is support for ongoing Commonwealth funding and the challenge is to find the most effective and financially sustainable model of delivery for psychological services in primary care.

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