BACKGROUND: Facilitation uses personal contact between the facilitator and the professional to encourage good practice and better service organisation. The model has been applied to physical illness but not to psychiatric disorders. AIM: To determine if a non-specialist facilitator can improve the recognition, management, and outcome of psychiatric illness presenting to general practitioners (GPs). METHOD: Six practices were visited over an 18-month period by a facilitator whose activities included providing guidelines and organising training initiatives. Six other practices acted as controls. Recognition (identification index of family doctors), management (psychotropic prescribing, psychological consultations with the GP, specialist mental health treatment, and the use of medical interventions and investigations), and patient outcome at four months were assessed before and after intervention. RESULTS: The mean identification index of facilitator GPs rose from 0.51 to 0.64 following intervention, while that of the control GPs fell from 0.67 to 0.59 (P = 0.046). The facilitator had no detectable effect on management or patient outcome. CONCLUSIONS: The facilitator improved recognition of psychiatric illness by GPs. Generic facilitators can be trained to take on a mental health role; however, the failure to achieve more fundamental changes in treatment and outcome implies that facilitator intervention requires development.
BACKGROUND: Facilitation uses personal contact between the facilitator and the professional to encourage good practice and better service organisation. The model has been applied to physical illness but not to psychiatric disorders. AIM: To determine if a non-specialist facilitator can improve the recognition, management, and outcome of psychiatric illness presenting to general practitioners (GPs). METHOD: Six practices were visited over an 18-month period by a facilitator whose activities included providing guidelines and organising training initiatives. Six other practices acted as controls. Recognition (identification index of family doctors), management (psychotropic prescribing, psychological consultations with the GP, specialist mental health treatment, and the use of medical interventions and investigations), and patient outcome at four months were assessed before and after intervention. RESULTS: The mean identification index of facilitator GPs rose from 0.51 to 0.64 following intervention, while that of the control GPs fell from 0.67 to 0.59 (P = 0.046). The facilitator had no detectable effect on management or patient outcome. CONCLUSIONS: The facilitator improved recognition of psychiatric illness by GPs. Generic facilitators can be trained to take on a mental health role; however, the failure to achieve more fundamental changes in treatment and outcome implies that facilitator intervention requires development.
Authors: Lisa A Cranley; Greta G Cummings; Joanne Profetto-McGrath; Ferenc Toth; Carole A Estabrooks Journal: BMJ Open Date: 2017-08-11 Impact factor: 2.692
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Authors: Whitney Berta; Lisa Cranley; James W Dearing; Elizabeth J Dogherty; Janet E Squires; Carole A Estabrooks Journal: Implement Sci Date: 2015-10-06 Impact factor: 7.327
Authors: Rachel Jenkins; Caleb Othieno; Stephen Okeyo; Dan Kaseje; Julyan Aruwa; Henry Oyugi; Paul Bassett; Felix Kauye Journal: Int J Ment Health Syst Date: 2013-11-05
Authors: Danielle F Loeb; Danielle M Kline; Kurt Kroenke; Cynthia Boyd; Elizabeth A Bayliss; Evette Ludman; L Miriam Dickinson; Ingrid A Binswanger; Samantha P Monson Journal: BMC Fam Pract Date: 2019-09-06 Impact factor: 2.497