Visser E A H, Kregting B H C M, Olde Hartman T C, Pop-Purceleanu M, van de Laar F A
Tijdschr Psychiatr. 2023;65(9):549-554.
The high demand for mental health care is increasing the pressure on Dutch basic and specialized mental health care. Consultative psychiatry in primary care may help to support primary mental health care. These consultations are increasingly used nationwide. However, little is known about how this help takes shape in practice and what the experiences of both patients and caregivers are.
We carried out a database and file study into the characteristics of the patients who received psychiatric consultation, in which we also examined the consultation questions of the general practitioners (GP) and the given advice. In addition, 15 semi-structured in-depth interviews were conducted with patients, general practitioners, mental healthcare nurse practitioners and psychiatrists, after which the transcripts were coded and analyzed thematically.
To explore for which patients the GP requests a psychiatric consultation, what the consultation questions are and the advice given, and to identify the experiences of patients and healthcare providers with consultative psychiatry in general practice.
The database study showed that consultative psychiatry was mainly used for patients with a psychiatric history, multiple psychiatric diagnosis and current psychopharmaceutical use. The consultation question usually concerned medication or treatment advice. In addition to advice regarding the consultation question, the psychiatrist often gave additional advice. Consultative psychiatry was experienced positively by both health care providers and patients due to the low threshold of the general practice, the mutual trust that is involved, the short waiting times compared to the second and third line psychiatry and the expertise of the psychiatrist.
Consultative psychiatry in general practice is widely applicable, but is mainly applied to patients with multiple psychiatric diagnoses and current psychopharmaceutical use. It is experienced as positive by both patients and healthcare providers.
对心理健康护理的高需求正在增加荷兰基础和专业心理健康护理的压力。初级保健中的咨询精神病学可能有助于支持初级心理健康护理。这些咨询在全国范围内的使用越来越多。然而，对于这种帮助在实践中如何形成以及患者和护理人员的体验如何，人们知之甚少。
我们对接受精神病学咨询的患者特征进行了数据库和档案研究，其中我们还检查了全科医生（GP）的咨询问题和给出的建议。此外，我们对患者、全科医生、精神卫生护理从业者和精神科医生进行了15次半结构化深入访谈，之后对访谈记录进行编码并进行主题分析。
探讨全科医生针对哪些患者进行精神病学咨询、咨询问题是什么以及给出了什么建议，并确定患者和医疗服务提供者对全科医疗中咨询精神病学的体验。
数据库研究表明，咨询精神病学主要用于有精神病史、多重精神诊断和当前正在使用精神药物的患者。咨询问题通常涉及药物或治疗建议。除了针对咨询问题的建议外，精神科医生通常还会给出额外的建议。由于全科医疗的低门槛、其中涉及的相互信任、与二线和三线精神病学相比等待时间短以及精神科医生的专业知识，医疗服务提供者和患者对咨询精神病学的体验都很积极。
全科医疗中的咨询精神病学广泛适用，但主要应用于有多重精神诊断和当前正在使用精神药物的患者。患者和医疗服务提供者都认为其是积极的。
