Tags

Type your tag names separated by a space and hit enter

Relationship style between GPs and community mental health teams affects referral rates.
Br J Gen Pract. 2002 Feb; 52(475):101-7.BJ

Abstract

BACKGROUND

Community mental health teams (CMHTs) are the established model for supporting patients with serious mental illness in the community. However, up to 25% of those with psychotic disorders are managed solely by primary care teams. Effective management depends upon locally negotiated referral and shared care arrangements between CMHTs and primary care.

AIM

To examine whether the style of working relationship between general practices and CMHTs affects the numbers and types of referrals from general practices to CMHTs, taking into account population and practice factors and provision of other mental health services which may influence referral rates.

DESIGN OF STUDY

Cross-sectional study.

SETTING

All 161 general practices in East London and the City Health Authority.

METHOD

Questionnaire survey to all general practices to identify style of relationship. Collection of routinely available referral data to all statutory mental health services over a two-year period. Main outcome measures were number and types of referrals from general practices to CMHTs.

RESULTS

The average annual referral rate to the eleven CMHTs in east London is 10 per 1000 adult population annually. The teams show a sixfold variation in rates of referral from all sources. Where good working relationships (a consultation-liaison style) exist between CMHTs and general practice, there are greater numbers of referrals requiring both long and short-term work by CMHTs. Two-stage multivariate models explained 47% of the referral variation between practices. Where primary care-based psychologists work with practices there are greater numbers of CMHT referrals, but less use of psychiatric services.

CONCLUSION

Shifting to a consultation-liaison relationship should increase rates of referral of patients with serious mental illness, including those who can most benefit from the skills of CMHTs. Increasing the provision of primary care-based psychology might improve practice use of mental health services, reducing avoidable outpatient psychiatric referrals.

Links

PMC Free PDF
PMC Free Full Text
FREE Publisher Full Text

Authors+Show Affiliations

Hull SA
Department of General Practice and Primary Care, Queen Mary and Westfield College, London. s.a.hull@qmw.ac.uk
Jones C
No affiliation info available
Tissier JM
No affiliation info available
Eldridge S
No affiliation info available
Maclaren D
No affiliation info available

MeSH

AdolescentAdultAgedCommunity Mental Health ServicesCross-Sectional StudiesFamily PracticeFemaleHumansInterprofessional RelationsLondonMalePractice Patterns, Physicians'Referral and ConsultationSurveys and Questionnaires

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11885819

Citation

Hull, S A., et al. "Relationship Style Between GPs and Community Mental Health Teams Affects Referral Rates." The British Journal of General Practice : the Journal of the Royal College of General Practitioners, vol. 52, no. 475, 2002, pp. 101-7.
Hull SA, Jones C, Tissier JM, et al. Relationship style between GPs and community mental health teams affects referral rates. Br J Gen Pract. 2002;52(475):101-7.
Hull, S. A., Jones, C., Tissier, J. M., Eldridge, S., & Maclaren, D. (2002). Relationship style between GPs and community mental health teams affects referral rates. The British Journal of General Practice : the Journal of the Royal College of General Practitioners, 52(475), 101-7.
Hull SA, et al. Relationship Style Between GPs and Community Mental Health Teams Affects Referral Rates. Br J Gen Pract. 2002;52(475):101-7. PubMed PMID: 11885819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship style between GPs and community mental health teams affects referral rates. AU - Hull,S A, AU - Jones,C, AU - Tissier,J M, AU - Eldridge,S, AU - Maclaren,D, PY - 2002/3/12/pubmed PY - 2002/4/16/medline PY - 2002/3/12/entrez SP - 101 EP - 7 JF - The British journal of general practice : the journal of the Royal College of General Practitioners JO - Br J Gen Pract VL - 52 IS - 475 N2 - BACKGROUND: Community mental health teams (CMHTs) are the established model for supporting patients with serious mental illness in the community. However, up to 25% of those with psychotic disorders are managed solely by primary care teams. Effective management depends upon locally negotiated referral and shared care arrangements between CMHTs and primary care. AIM: To examine whether the style of working relationship between general practices and CMHTs affects the numbers and types of referrals from general practices to CMHTs, taking into account population and practice factors and provision of other mental health services which may influence referral rates. DESIGN OF STUDY: Cross-sectional study. SETTING: All 161 general practices in East London and the City Health Authority. METHOD: Questionnaire survey to all general practices to identify style of relationship. Collection of routinely available referral data to all statutory mental health services over a two-year period. Main outcome measures were number and types of referrals from general practices to CMHTs. RESULTS: The average annual referral rate to the eleven CMHTs in east London is 10 per 1000 adult population annually. The teams show a sixfold variation in rates of referral from all sources. Where good working relationships (a consultation-liaison style) exist between CMHTs and general practice, there are greater numbers of referrals requiring both long and short-term work by CMHTs. Two-stage multivariate models explained 47% of the referral variation between practices. Where primary care-based psychologists work with practices there are greater numbers of CMHT referrals, but less use of psychiatric services. CONCLUSION: Shifting to a consultation-liaison relationship should increase rates of referral of patients with serious mental illness, including those who can most benefit from the skills of CMHTs. Increasing the provision of primary care-based psychology might improve practice use of mental health services, reducing avoidable outpatient psychiatric referrals. SN - 0960-1643 UR - https://www.unboundmedicine.com/medline/citation/11885819/Relationship_style_between_GPs_and_community_mental_health_teams_affects_referral_rates_ L2 - https://bjgp.org/cgi/pmidlookup?view=long&pmid=11885819 DB - PRIME DP - Unbound Medicine ER -