Management of mental health problems by general practitioners in Quebec

Article Figures & Data

Table 1

Comparison between 2 samples of GPs (survey group and interview group) and the total population of GPs in Quebec

CHARACTERISTIC	SURVEY GROUP (N = 398)	INTERVIEW GROUP (N = 60)	P VALUE FOR χ²	*GPs IN QUEBEC,^ %**	P VALUE FOR χ²
Age,^† y, n (%)			.350		.350
• < 35	29 (7.3)	1 (1.7)		13.7
• 35–44	112 (28.1)	9 (15.0)		27.5
• 45–54	170 (42.7)	24 (40.0)		35.0
• 55–64	74 (18.6)	22 (36.7)		18.3
• ≥ 65	13 (3.3)	4 (6.7)		5.5
Sex, n (%)			.670		.322
• Male	194 (48.7)	29 (48.3)		55.1
• Female	204 (51.3)	31 (51.7)		44.9
Mean (SD) percentage of fee for service	64.9 (39.8)	54.8 (37.8)	.149	74.0	.005

↵* Data from Savard and Rodrigue.¹⁴
↵† Mean (SD) age of GPs who took part in the survey was 48 (9) y. Mean age of GPs who took part in the interviews was 52 (8) y.

Table 2

Profiles of GPs and patients: N = 398 respondents.

	TYPE OF MHP
CHARACTERISTIC	MHP	CMHP	SMHP
GP practice settings and hours worked, mean (SD)
• No. of practice settings^*	2 (1.0)
• Hours worked per wk	43 (12.8)
GP clinical profiles, n (%)
• GPs who manage MHPs^{^†^‡}	360 (90.5)	354 (88.9)	304 (76.4)
• GPs who monitor medication		243 (61.1)	195 (49.0)
• GPs who provide support therapy		236 (59.3)	139 (34.9)
Patient profiles, mean (SD)
• Patients seen each wk for all reasons	90.0 (42.0)
• Patients seen each wk for mental health issues	22.5 (25.0)	19.9 (88.5)	2.6 (11.5)
• Proportion of patients presenting with MHPs	25.0 (19.0)
• Patients with MHPs whose care is managed by GPs, out of the patients seen per wk for MHPs		13.7 (69.0)	0.8 (34.0)

CMHP—common mental health problem, MHP—mental health problem, SMHP—serious mental health problem.
↵* For the sample of 60 GPs who were interviewed, the mean (SD) number of practice settings is 2.8 (1.2).
↵† For the sample of 60 GPs who were interviewed, the number (percent) is 60 (100) for MHPs.
↵‡ GPs answered a yes or no question, and had at least 1 patient.

Table 3

Patients in Quebec older than 18 y who consulted GPs: Régie de l'assurance maladie du Québec administrative data.

CATEGORY	CONSULTED AT LEAST ONCE FOR REASONS OF MENTAL HEALTH	CONSULTED FOR A REASON OTHER THAN MENTAL HEALTH	TOTAL PATIENTS WHO CONSULTED GPS
No. of patients in 2006	909 850	3 630 824	4 540 674
Patients in Quebec older than 18 y in 2006, %	15.0	59.9	74.9
Change since 2002, %	+ 6.6	+ 3.1	+ 3.1
Patients who consulted GPs in 2006, %	20.0	80.0	100

Table 4

Interprofessional collaboration between GPs and mental health professionals according to survey: N = 398.

CATEGORY	FREQUENCY, %
GPs who referred or transferred patients owing to the following:
• Severity of MHP	67.1
• Complexity of case	70.4
• Lack of support from psychiatrists	28.5
• Lack of expertise in mental health	11.3
• Lack of interest in mental health	4.4
• Lack of financial incentives	8.5
GPs who reported that the mental health system is adequate or very adequate, with respect to the following:
• Health system as a whole	55.0
• Geographic accessibility	64.0
• Hours of operation	59.0
• Range of services	54.0
• Continuity of services	46.0
• Availability of services	35.0
• Accessibility of mental health professionals	27.0