[Tackling mental health problems from primary care: relationship with specialized support services].

OBJECTIVES: To find the relationship between primary care (PC) and mental health (MH) by evaluating: 1) perception of MH problems in PC: training of professionals and doctor-patient relationship, and 2) relationship between PC and specialist support services: coordination meetings and reasons for referrals.
DESIGN: Descriptive study.
SETTING: Seven PC centres that share the same mental health centre in the Girona Health Region. PARTICIPANTS: All the PC doctors from the 7 centres (n = 66).
MEASUREMENTS AND MAIN RESULTS: Specific, anonymous and self-administered survey, with 71 Likert-type items, distributed in 14 fields. 51 replies (77.2%). 60.4% valued positively their MH training. 100% thought that a good doctor-patient relationship improves adherence to treatment, and 76.5% saw this hindered by lack of time. Aggressive and manipulative patients caused a higher level of tension (70.6% and 66.7%). The point most highly valued of their relationship with the MH centre was its support in patient follow-up (69.6%) and the agreement to share responsibilities for treatment of mental disorders (71.1%). The forms of support most valued were: inter-clinical meetings (80.4%) and inter-clinic telephone consultations (78.4%). The factors most conditioning referral to the MH centre were ideas of suicide (96.1%) and the seriousness of the symptoms (94%).
CONCLUSIONS: Greater MH training should be offered to PC doctors. PC doctors think they have little time available to devote to their psychiatric patients. Availability of a specialist PC support team is essential.