Mental health and psychiatry training in primary care residency programs

Leigh, Hoyle; Stewart, Deborah; Mallios, Ronna

doi:10.1016/j.genhosppsych.2005.10.004

Cited by 37 publications

(22 citation statements)

References 12 publications

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“…This pattern is consistent with the traditional role of primary care physicians in delivering basic mental health services. 15 Therefore, in addition to examining trends in visits to all nonpsychiatrist physicians, we separately examined trends in visits to primary care physicians and to other nonpsychiatrist physicians.…”

Section: Study Resultsmentioning

confidence: 99%

Proportion Of Antidepressants Prescribed Without A Psychiatric Diagnosis Is Growing

2011

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Over the past two decades, the use of antidepressant medications has grown to the point that they are now the third most commonly prescribed class of medications in the United States. Much of this growth has been driven by a substantial increase in antidepressant prescriptions by nonpsychiatrist providers without an accompanying psychiatric diagnosis. Our analysis found that between 1996 and 2007, the proportion of visits at which antidepressants were prescribed but no psychiatric diagnoses were noted increased from 59.5 percent to 72.7 percent. These results do not clearly indicate a rise in inappropriate antidepressant use, but they highlight the need to gain a deeper understanding of the factors driving this national trend and to develop effective policy responses. To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers' prescribing practices, revamp drug formularies, or vigorously pursue implementation of broad reforms of the health care system that will increase communication between primary care providers and mental health specialists.

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Section: Study Resultsmentioning

confidence: 99%

Proportion Of Antidepressants Prescribed Without A Psychiatric Diagnosis Is Growing

2011

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“…Estos factores podrían explicar parte de las diferencias observadas en CT entre médicos chilenos y extranjeros, lo que coincide con los resultados generales del Examen Único Nacional Manejo de la depresión por médicos generales -J. Acuña et al en HD y HT, lo cual podría responder a la mayor complejidad de estas destrezas, aspecto que ha sido considerado en la elaboración de los programas de pregrado de distintas universidades en Chile, particularmente a través del internado de psiquiatría obligatorio 31,41 . Pese a lo anterior, se considera que aún se requiere de entrenamiento de postítulo en esta materia 35,36 . Asimismo se podría plantear que estos resultados reflejan una medición con un nivel de exigencia relativamente alto, ya que al tratarse de habilidades complejas se necesitan métodos de evaluación también complejos que incluyan varias mediciones y formatos diferentes 26,27,30,35,36 .…”

Section: Discussionunclassified

“…Pese a lo anterior, se considera que aún se requiere de entrenamiento de postítulo en esta materia 35,36 . Asimismo se podría plantear que estos resultados reflejan una medición con un nivel de exigencia relativamente alto, ya que al tratarse de habilidades complejas se necesitan métodos de evaluación también complejos que incluyan varias mediciones y formatos diferentes 26,27,30,35,36 . Por ello un desafío importante del estudio consistió en la elaboración de la metodología de evaluación que buscó dar cuenta del razonamiento clínico en aspectos diagnósticos y terapéuticos, como parte de la competencia clínica 26 .…”

Section: Discussionunclassified

“…Si bien la formación médica de pregrado en Chile se encuentra en la etapa de implementación de un currículum basado en competencias [31][32][33][34] , se ha planteado que ésta resulta insuficiente en materia de psiquiatría y salud mental, ya sea por limitaciones de tiempo o por tratarse de objetivos formativos complejos que requieren metodologías de enseñanza-aprendizaje difíciles de implementar 31 ; por lo tanto, como advierte Leigh y cols. 35,36 se requiere de formación de postítulo en estas materias. Por ello, se observa un giro de la investigación en educación médica hacia la evaluación de conocimiento aplicado, de habilidades y actitudes en la relación clínica como componentes de la competencia profesional 23,25 .…”

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Habilidades clínicas para el manejo de trastornos depresivos en médicos generales en Santiago de Chile

et al. 2016

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“…6, 7 Individuals with mental illness encounter numerous barriers to accessing health care, which could negatively influence adherence to CRC screening guidelines among this population. 8 These barriers include limitations in training of health care professionals related to assisting patients with mental illness 9,10 and limited access to primary and preventive health services. 11 …”

Section: Introductionmentioning

confidence: 99%

Mental Illness Is Not Associated with Adherence to Colorectal Cancer Screening: Results from the California Health Interview Survey

Siantz

Shiroishi

et al. 2016

Dig Dis Sci

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Background Colorectal cancer is the second leading cause of cancer-specific death in the United States. Evidence suggests people with mental illness are less likely to receive preventive health services, including cancer screening. We hypothesized that mental illness is a risk factor for nonadherence to colorectal cancer screening guidelines. Methods We analyzed results of the 2007 California Health Interview Survey to test whether mental illness is a risk factor for non-adherence to colorectal cancer screening recommendations among individuals age 50 or older (N = 15,535). This cross-sectional dataset is representative of California. Screening was defined as either fecal occult blood testing during the preceding year, sigmoidoscopy, or colonoscopy during the preceding 5 years. Mental illness was identified using the Kessler K6 screening tool. Associations were evaluated using weighted multivariate logistic regressions. Results Mental illness was not associated with colorectal cancer screening adherence (OR, 0.89; 95% CI, 0.63-1.25). Risk factors for nonadherence included being female (OR, 1.25; 95% CI, 1.09-1.44); delaying accessing health care during the previous year (OR; 1.89; 95% CI, 1.56-2.29). Conclusions Unlike previous studies, this study did not find a relationship between mental illness and colorectal cancer screening adherence. This could be due to differences in study populations. State-specific health care policies involving care coordination for individuals with mental illness could also influence colorectal cancer screening adherence in California.

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Mental health and psychiatry training in primary care residency programs

Cited by 37 publications

References 12 publications

Proportion Of Antidepressants Prescribed Without A Psychiatric Diagnosis Is Growing

Proportion Of Antidepressants Prescribed Without A Psychiatric Diagnosis Is Growing

Habilidades clínicas para el manejo de trastornos depresivos en médicos generales en Santiago de Chile

Mental Illness Is Not Associated with Adherence to Colorectal Cancer Screening: Results from the California Health Interview Survey

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