PubMed · 10141808
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J W Britton, D R Wood. Developing a customized outcomes program.. https://pubmed.ncbi.nlm.nih.gov/10141808/
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Because of their disease mentally ill persons are often unable to request and receive necessary help on their own. Hence, local authorities have the legal duty to offer support in subsidiary or complementary ways or to organize help together with other participants concerned with psychiatric care. If the transition from community care to the differently structured regular health care system is too fast there is a danger of worsening of the symptoms. In the city of Bochum health insurance bodies agreed to take over the costs of therapy for mentally ill people via the sociopsychiatric services within the scope of crisis intervention. Background information on the sociopsychiatric services of the city of Bochum is given.
BACKGROUND: The Clinical Standards Advisory Group (CSAG) was asked by UK health ministers to advise on the standards of clinical care attainable for people with depression. The GP survey reported here is one part of a multicomponent UK-wide study of services for depression that also included visits to a sample of services and structured patient telephone interviews. OBJECTIVES: The aim of this study was to survey GPs' perceptions of the availability and quality of primary and community-based services for people with depression, and to seek their views on barriers to the provision of good clinical services. METHODS: A structured postal questionnaire was sent to all GPs (3530) in the 11 geographical areas visited during the CSAG study. RESULTS: A total of 1703 (48%) GPs returned the questionnaire. The main obstacles to providing a good service for people with depression included not having enough time, a lack of services to refer to and difficulty in accessing services. More than half of the respondents (58%) were aware of guidelines for the management of depression, and 62% had attended a teaching session on depression within the last 3 years. Factors that influenced GPs to refer people with depression to other services were risk to the patient, a clear need for specialist treatment and the need for assessment. Overall, GPs appeared to be satisfied with the quality of specialist services. CONCLUSIONS: GPs appeared to view obstacles to providing effective treatment of depression as being more allied to external issues, in particular service provision, rather than internal factors such as their own knowledge and skills. The study revealed continuing concerns over excessive workload, and longstanding difficulties with the interface between primary and secondary mental health services.
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