Use of adult psychiatric services by primary care physicians in midwestern cities.

Primary care physicians in the tri-state area of Nebraska, Iowa and South Dakota were surveyed concerning their baseline practices in requesting psychiatric consultations, and their recommendations for improvement in psychiatric consultation. A two-page questionnaire was used to collect data. The information obtained was analyzed by tetrachoric correlations. Our results indicate that most primary care physicians refer patients to psychiatrists and prescribe psychotropic medications. It was generally noted that the respondents do not do psychotherapy themselves. In contrast to studies from other areas, our research showed that the symptoms which prompted psychiatric referral the most are psychosis and depression. Suggestions for improvement in psychiatric consultations included that psychiatrists need to be more available to the primary care practitioner. It was also indicated that financial constraints, social stigma and psychiatric shortage were problems in referral of patients to psychiatrists.