Psychiatrists Working in Primary Care: A Survey of General Practitioners' Attitudes

Objectives: To collect information on current working arrangements between general practitioners (GPs) and mental health professionals and to assess GPs' attitudes towards developing closer working practices with psychiatrists in the primary care setting. Method: Six hundred and three GPs from South Australia were surveyed with questionnaires. Main outcome measures included information about existing primary care links between GPs and mental health professionals, GPs' preferred working arrangements with psychiatrists in the primary care setting and their attitude towards developing these practices, including perceived obstacles, advantages and disadvantages. Results: One hundred and eighty-one completed questionnaires were returned. One in 11 GPs returning the questionnaire (RGPs) had established primary care links with a psychiatrist, 1 in 6 with clinical psychologists and 1 in 17 with psychiatric nurses and social workers. RGPs held positive attitudes towards developing closer links at their work settings with psychiatrists when it leads to improved collaboration and access to psychiatrists. Reservations were expressed about the public weakening of the GPs' primary care role. Conclusions: The joint needs of clinical care and GPs' further training in psychiatry could be addressed by further development of schemes to attract psychiatrists to work in primary care settings. This is mostly viewed very positively by GPs, although the percentage of GPs responding make these conclusions tentative. It is more likely to occur with changes to current funding of both private psychiatric care and GP remuneration, with a recognition of time spent in liaison.