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Counsellors in Primary Care: Benefits and Lessons Learned

TLDR
A Canadian program that brings counsellors and psychiatrists into the offices of 87 family physicians in 36 practices in a community of 460 000 in Southern Ontario has effectively integrated counsellor within primary care settings, increasing the capacity of primary care to handle mental health problems, strengthening links between providers from different sectors, and making mental health care more accessible.
Abstract
Objectif : Decrite un programme qui integre les intervenants en sante en sante mentale aux soins primaires, presenter les donnees sur l'effet du programme et discuter des lecons qui en ont ete tirees et qui peuvent s'appliquer a d'autres communautes. Methodes : Cet article decrit un programme canadien qui rassemble intervenants et psychiatres dans les bureaux de 87 medecins de famille, dans 36 pratiques d'une communaute de 460 000 personnes du sud de l'Ontario. Il decrit les objectifs et l'organisation du programme ainsi que les activites des intervenants qui travaillent dans un cadre de soins primaires. En outre, l'article resume les donnees de l'evaluation du programme, y compris les donnees demographiques, les problemes individuels rencontres et les services dispenses - provenant tous de la base de donnees du programme, plus precisement, les donnees sur les resultats des patients obtenus a l'aide des questionnaires suivants : le questionnaire sur l'etat de sante general (GHQ), l'echelle de depression du centre des etudes epidemiologiques (CESD) et des questionnaires sur la satisfaction des consommateurs. Resultats : Chaque intervenant voit en moyenne 161 nouveaux cas par annee. Les problemes sont majoritairement la depression, l'anxiete et les problemes familiaux. En fait, plus de 70 % des personnes qui consultent presentent des ameliorations significatives des resultats. Le programme a entraine un accroissement significatif de l'acces aux services de sante mentale, une reduction du recours aux services classiques de sante mentale, des niveaux eleves de satisfaction concernant les intervenants et les medecins de famille, et des ameliorations significatives des symptomes et du fonctionnement des personnes vues. Conclusion : Ce programme a integre efficacement les intervenants a des cadres de soins primaires, accroissant ainsi la capacite de ces derniers de traiter les problemes de sante mentale, consolidant les liens entre les fournisseurs de differents secteurs et rendant les soins de sante mentale plus accessibles.

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References
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Journal ArticleDOI

Counsellors in English and Welsh general practices: their nature and distribution.

TL;DR: Counselling services are wide-spread in general practice, but a high proportion of counsellors lack qualifications, and many may be referred problems outside their knowledge.
Journal ArticleDOI

Community psychiatric nurses in primary health care.

TL;DR: The results add weight to the argument that CPNs should refocus their activity on people with serious mental health problems, and indicate thatCPN education should focus on skill acquisition and interventions of proven effectiveness.
Journal ArticleDOI

Shared mental health care in Canada.

TL;DR: The family physician already plays an extensive role as a provider of mental health care in almost every community in Canada, but too often family physicians and psychiatrists fail to establish the collaborative working relationships that would strengthen the role of the family physician, enhance the consultative role of, and improve the quality of care their patients receive.
Journal ArticleDOI

Psychological consultation with primary care physicians : obstacles and opportunities in the medical setting

TL;DR: The training and practice of physicians in the areas of mental and behavioral health care is described and an integrated behavioral systems model of psychological consultation is presented as a potentially effective model for consultation with primary care physicians.
Journal ArticleDOI

Integrating mental health services within primary care: A Canadian program

TL;DR: The program made mental health care more available and accessible, increased continuity of care, provided additional support for the family physician, offered new opportunities for continuing education, and led to a reduced and more efficient use of other mental health services.
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This program has effectively integrated counsellors within primary care settings, increasing the capacity of primary care to handle mental health problems, strengthening links between providers from different sectors, and making mental health care more accessible.