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Healthc Policy. 2010 May;5(4):90-104.

Clinical Practice Settings Associated with GPs Who Take on Patients with Mental Disorders.

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Associate Professor, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, QC.


In light of current reforms to reinforce primary mental healthcare and service integration, this paper assesses general practitioners' (GPs') management of patients with mental disorders (PMD) and its associated practice settings and clinical characteristics. The study is based on a survey of 398 Quebec GPs. Results showed that GPs who receive patients with moderate and transient mental disorders (PMD-M) usually follow them on a continuous basis; conversely, only a quarter of GPs who see patients with severe and persistent mental disorders (PMD-S) provide follow-up. With the exception of walk-in clinics, all clinical settings are associated with GPs who take on PMD-M. No setting was found to be significantly associated with GPs taking on PMD-S. Competency, skills and confidence seem to be core factors in decisions to take on PMD. Group practice models (CLSCs, network clinics) and shared-care initiatives should be encouraged to manage more complex PMD cases.


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