Preparedness of Lithuanian general practitioners to provide mental healthcare services: a cross-sectional survey

Abstract

BackgroundA large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners’ (GPs) experience in mental healthcare and their perceptions about how to increase their involvement in the field.MethodsIn this cross-sectional study, a 41-item questionnaire was distributed to a random sample of 797 Lithuanian GPs in order to investigate current practices in their provision of mental healthcare as well as their suggestions for the improvement of mental healthcare services in primary care.ResultsThe response rate was 52.2%. Three-quarters of the GPs agreed that they feel responsible for the management of mental health problems, but only 8.8% of them agreed that “My knowledge in mental healthcare is sufficient”. Psychiatrists were identified as the mental healthcare team specialists with whom 32% of the respondents discuss the management of their patients with a mental disorder. Collaboration with psychologists and social workers was almost threefold lower (11.6% and 12.5%). Capacity-building of GPs was found to be among the most promising initiatives to improve mental health services in primary care. Other strategies mentioned were policy level and managerial measures as well as strengthening the teamwork approach in mental healthcare.ConclusionsThis study found a low self-reported competence of GPs in mental healthcare and low collaboration among GPs and other specialists in providing mental healthcare. For the situation to improve in the country, these findings point to a need for strategies to improve GPs’ expertise and teamwork in mental healthcare.

Mental health in primary care: an evaluation using the Item Response Theory

“…Studies have indicated the need for supervision and training of PHCT for the adequate care of patients in psychological distress 16 , 17 , 22 , 27 . The matrix support would be able to increase the resolutiveness and the effectiveness of the actions, acting together with the PHCT in their territory, subsidizing group activities, health promotion actions, and training of PHC professionals 7 , 11 .…”

“…An important factor for the treatment of persons in mental distress by the PHC is the qualification of professionals. These professionals have reported feeling unprepared for such care 13 , 16 , 17 , 21 , 22 .…”

Insights into the system of care of the elderly with mental disorders from the perspective of informal caregivers in Lithuania

“…The formal network of the health and social care systems is complicated and depends on the specific different legal frameworks, policies and separate financing [9]. Navigation through this network is challenging to the patients, their caregivers, and to health care professionals [10]. Eventually, teamwork and collaboration between the health and social care sectors become challenging: investigation of the cross-sector service delivery in health and social care highlights the necessity for delineating existing facilitators and barriers in cross-sector collaboration and use them to shape a common vision of care across different sectors [11].…”

“…Fragmentation of health and social care is also an issue in Lithuania where there is a lack of collaboration between family physicians and social workers [10]. It is especially problematic in the context of financial strain—spending’s on social protection per person in Lithuania reach nearly half of the EU average [12].…”

“…Research has shown that legislative attempts to foster collaboration between these sectors had a low impact on service provision and left organisational frameworks unchanged [13, 14]. Moreover, research has also proved that in the care for mentally ill patients in PHC the level of collaboration within the healthcare sector in Lithuania was very low [10].…”