Collaboration médecine-psychologie : évolution des mentalités en Belgique et évolution du système de soins de santé au Canada

Abstract

L’expertise des psychologues dans l’évaluation et la prise en charge des troubles communs de santé mentale comme l’anxiété et la dépression qui sont fréquents en soins primaires et co-morbides avec les maladies chroniques font des psychologues une ressource essentielle pour les médecins. Les psychologues représentent un large bassin de professionnels spécialisés dans le diagnostic et la pratique de la psychothérapie ; la collaboration médecins-psychologues est d’autant plus critique dans le contexte visant à augmenter l’accès des populations aux traitements psychologiques et aux psychothérapies. Cet article se veut un regard sur l’état de la collaboration entre médecins et psychologues en Belgique et au Canada. Il examine l’évolution des mentalités entre ces deux professions dans une perspective européenne belge et la façon dont le contexte et le système de soins de santé publique au Canada influencent le potentiel de collaboration entre ces deux professions. Les études démontrent la volonté et la facilité qu’ont ces deux professions à collaborer. Mais ceci doit être appuyé par des structures systémiques et académiques facilitantes notamment dans l’apprentissage précoce à la collaboration dans le cursus de ces professions.Objectives 1) To give a portrait of the evolving mentalities prevailing in Belgium on the collaboration between psychologists and general practitioners, and identify the barriers to the development of the collaboration between those two health professionals 2) To report on the primary care reform in Canada, its role in fostering collaborative practice in primary mental health and on the strategies needed to improve collaboration.Methods Literature search using PubMed and Google Scholar.Results Because of the unmet need of psychologists in primary care, general practitioners and psychologists have a propensity to work together. However to facilitate the collaborative process there needs to be system changes and clear definition of scopes of practices. Both countries are at different levels of implementing change. In Belgium for example it is only very recently that the autonomous practice of clinical psychology has been acknowledged. In Canada although the primary care reform has put forward and supported collaborative care, focus on mental health is insufficient. Early reports on collaborative care in the new models of care inconsistently report improved health outcomes. Strategies to improve collaborative care are looking at teaching future health professionals on how to work together by integrating inter-professional education.Conclusion Both the health care system and graduate training need to support foster and teach collaborative care

Collaboration between mental health professionals and physicians in the assessment of torture victims in a conflict-ridden area: Complexities and recommendations.

“…In another Canadian study, psychologists and physicians identified referral or informal consultation as the optimal form of collaboration in primary care (Farmanova et al, 2017). It was suggested to incorporate the teaching of collaborative and interprofessional practices into the curriculum of health science students, specifically physicians and psychologists (Chomienne et al, 2015).…”

“…MHPs and physicians, though, have different working methods that may be different enough to cause friction, misunderstanding, or confusion, which can result in significant tension between the clinicians related to their respective professional identities (cf. Chomienne et al, 2015).…”

“…The study asserted that collaboration in Belgium is in its infancy. In Canada, where such collaboration is much more developed, physicians still lack openness to cooperation (Chomienne et al, 2015). In another Canadian study, psychologists and physicians identified referral or informal consultation as the optimal form of collaboration in primary care (Farmanova et al, 2017).…”