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Published in: Administration and Policy in Mental Health and Mental Health Services Research 6/2015

01-11-2015 | Original Article

Obstacles in Managing Mental Health Problems for Primary Care Physicians in Hong Kong

Authors: Kai Sing Sun, Tai Pong Lam, Kwok Fai Lam, Tak Lam Lo

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 6/2015

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Abstract

This study investigated the obstacles for primary care physicians (PCPs) to managing mental health problems in Hong Kong. Focus group data collected from PCPs and psychiatrists were used to construct a questionnaire for a quantitative survey with 516 PCPs respondents. The results showed that their commonly perceived obstacles were lack of timely access to public psychiatrists, lack of feedback from both public and private psychiatrists after referrals; as well as patients’ reluctance to be referred. Factor analysis and correlational analysis found that the numbers of mental health patients treated by the PCPs were mainly determined by the PCPs’ own clinical constraints, including limited confidence in diagnosis and management, time constraint, and limited job satisfaction.
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Literature
go back to reference Bergman, M. M. (2010). On concepts and paradigms in mixed methods research. J Mix Methods Res, 4(3), 171–175.CrossRef Bergman, M. M. (2010). On concepts and paradigms in mixed methods research. J Mix Methods Res, 4(3), 171–175.CrossRef
go back to reference Bridges, K. W., & Goldberg, D. P. (1985). Somatic presentation of DSM III psychiatric disorders in primary care. J Psychosom Res, 29(6), 563–569.CrossRefPubMed Bridges, K. W., & Goldberg, D. P. (1985). Somatic presentation of DSM III psychiatric disorders in primary care. J Psychosom Res, 29(6), 563–569.CrossRefPubMed
go back to reference Centre for Health Protection. (2005). Non-communicable Diseases Aware (Vol. 2). Hong Kong: Centre for Health Protection. Centre for Health Protection. (2005). Non-communicable Diseases Aware (Vol. 2). Hong Kong: Centre for Health Protection.
go back to reference Creswell, J. W. (2010). Mapping the developing landscape of mixed methods research. In A. Tashakkori & C. Teddlie (Eds.), SAGE handbook of mixed methods in social & behavioral research (2nd ed., pp. 45–68). Thousand Oaks: SAGE Publications. Creswell, J. W. (2010). Mapping the developing landscape of mixed methods research. In A. Tashakkori & C. Teddlie (Eds.), SAGE handbook of mixed methods in social & behavioral research (2nd ed., pp. 45–68). Thousand Oaks: SAGE Publications.
go back to reference Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291(21), 2581–2590.CrossRefPubMed Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291(21), 2581–2590.CrossRefPubMed
go back to reference Fleury, M. J., Imboua, A., Aube, D., Farand, L., & Lambert, Y. (2012). General practitioners’ management of mental disorders: a rewarding practice with considerable obstacles. BMC Fam Pract, 13, 19.PubMedCentralCrossRefPubMed Fleury, M. J., Imboua, A., Aube, D., Farand, L., & Lambert, Y. (2012). General practitioners’ management of mental disorders: a rewarding practice with considerable obstacles. BMC Fam Pract, 13, 19.PubMedCentralCrossRefPubMed
go back to reference Furnham, A., & Chan, E. (2004). Lay theories of schizophrenia. A cross-cultural comparison of British and Hong Kong Chinese attitudes, attributions and beliefs. Soc Psychiatry and Psychiatr Epidemiol, 39(7), 543–552.CrossRef Furnham, A., & Chan, E. (2004). Lay theories of schizophrenia. A cross-cultural comparison of British and Hong Kong Chinese attitudes, attributions and beliefs. Soc Psychiatry and Psychiatr Epidemiol, 39(7), 543–552.CrossRef
go back to reference Garcia-Campayo, J., Sanz-Carrillo, C., Yoldi-Elcid, A., Lopez-Aylon, R., & Monton, C. (1998). Management of somatisers in primary care: are family doctors motivated? Aust N Z J Psychiatry, 32(4), 528–533.CrossRefPubMed Garcia-Campayo, J., Sanz-Carrillo, C., Yoldi-Elcid, A., Lopez-Aylon, R., & Monton, C. (1998). Management of somatisers in primary care: are family doctors motivated? Aust N Z J Psychiatry, 32(4), 528–533.CrossRefPubMed
go back to reference Gold, M. R., Mittler, J., Aizer, A., Lyons, B., & Schoen, C. (2001). Health insurance expansion through states in a pluralistic system. J Health Polit Policy Law, 26(3), 581–615.CrossRefPubMed Gold, M. R., Mittler, J., Aizer, A., Lyons, B., & Schoen, C. (2001). Health insurance expansion through states in a pluralistic system. J Health Polit Policy Law, 26(3), 581–615.CrossRefPubMed
go back to reference Goldberg, D. P., & Lecrubier, Y. (1995). Form and frequency of mental disorders across centres. In B. Ustun & N. Sartorius (Eds.), Mental illness in general health care: an international study (pp. 323–334). Chichester: WHO, John Wiley. Goldberg, D. P., & Lecrubier, Y. (1995). Form and frequency of mental disorders across centres. In B. Ustun & N. Sartorius (Eds.), Mental illness in general health care: an international study (pp. 323–334). Chichester: WHO, John Wiley.
go back to reference Hickie, I. B., Davenport, T. A., Scott, E. M., Hadzi-Pavlovic, D., Naismith, S. L., & Koschera, A. (2001). Unmet need for recognition of common mental disorders in Australian general practice. Med J Aust, 175(Suppl), S18–S24.PubMed Hickie, I. B., Davenport, T. A., Scott, E. M., Hadzi-Pavlovic, D., Naismith, S. L., & Koschera, A. (2001). Unmet need for recognition of common mental disorders in Australian general practice. Med J Aust, 175(Suppl), S18–S24.PubMed
go back to reference Hickie, I., & Groom, G. (2002). Primary care-led mental health service reform: an outline of the better outcomes in mental health care initiative. Australas Psychiatry, 10(4), 376–382.CrossRef Hickie, I., & Groom, G. (2002). Primary care-led mental health service reform: an outline of the better outcomes in mental health care initiative. Australas Psychiatry, 10(4), 376–382.CrossRef
go back to reference Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qual Health Res, 15(9), 1277–1288.CrossRefPubMed Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qual Health Res, 15(9), 1277–1288.CrossRefPubMed
go back to reference Jackson, J. L., Passamonti, M., & Kroenke, K. (2007). Outcome and impact of mental disorders in primary care at 5 years. Psychosom Med, 69(3), 270–276.CrossRefPubMed Jackson, J. L., Passamonti, M., & Kroenke, K. (2007). Outcome and impact of mental disorders in primary care at 5 years. Psychosom Med, 69(3), 270–276.CrossRefPubMed
go back to reference Lagomarsino, G., de Ferranti, D., Pablos-Mendez, A., Nachuk, S., Nishtar, S., & Wibulpolprasert, S. (2009). Public stewardship of mixed health systems. Lancet, 374(9701), 1577–1578.CrossRefPubMed Lagomarsino, G., de Ferranti, D., Pablos-Mendez, A., Nachuk, S., Nishtar, S., & Wibulpolprasert, S. (2009). Public stewardship of mixed health systems. Lancet, 374(9701), 1577–1578.CrossRefPubMed
go back to reference Lam, T. P., Goldberg, D., Tse, E. Y., Lam, K. F., Mak, K. Y., & Lam, E. W. (2011). What do primary care doctors get out of a year-long postgraduate course in community psychological medicine? Int J Psychiatry Med, 42(2), 133–149.CrossRefPubMed Lam, T. P., Goldberg, D., Tse, E. Y., Lam, K. F., Mak, K. Y., & Lam, E. W. (2011). What do primary care doctors get out of a year-long postgraduate course in community psychological medicine? Int J Psychiatry Med, 42(2), 133–149.CrossRefPubMed
go back to reference Lee, S., Tsang, A., & Kwok, K. (2007). Twelve-month prevalence, correlates, and treatment preference of adults with DSM-IV major depressive episode in Hong Kong. J Affect Disord, 98(1–2), 129–136.CrossRefPubMed Lee, S., Tsang, A., & Kwok, K. (2007). Twelve-month prevalence, correlates, and treatment preference of adults with DSM-IV major depressive episode in Hong Kong. J Affect Disord, 98(1–2), 129–136.CrossRefPubMed
go back to reference Leung, G. M., Ho, L. M., Chan, M. F., Johnston, J. M., & Wong, F. K. (2002). The effects of cash and lottery incentives on mailed surveys to physicians: a randomized trial. J Clin Epidemiol, 55(8), 801–807.CrossRefPubMed Leung, G. M., Ho, L. M., Chan, M. F., Johnston, J. M., & Wong, F. K. (2002). The effects of cash and lottery incentives on mailed surveys to physicians: a randomized trial. J Clin Epidemiol, 55(8), 801–807.CrossRefPubMed
go back to reference MaGPIe Research Group. (2005). General practitioners’ perceptions of barriers to their provision of mental healthcare: a report on Mental Health and General Practice Investigation (MaGPIe). N Z Med J, 118(1222), U1654. MaGPIe Research Group. (2005). General practitioners’ perceptions of barriers to their provision of mental healthcare: a report on Mental Health and General Practice Investigation (MaGPIe). N Z Med J, 118(1222), U1654.
go back to reference Murrihy, R. C., Byrne, M. K., & Gonsalvez, C. J. (2009). Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion. Med Educ, 43(2), 140–145.CrossRefPubMed Murrihy, R. C., Byrne, M. K., & Gonsalvez, C. J. (2009). Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion. Med Educ, 43(2), 140–145.CrossRefPubMed
go back to reference Naismith, S. L., Hickie, I. B., Scott, E. M., & Davenport, T. A. (2001). Effects of mental health training and clinical audit on general practitioners’ management of common mental disorders. Med J Aust, 175(Suppl), S42–S47.PubMed Naismith, S. L., Hickie, I. B., Scott, E. M., & Davenport, T. A. (2001). Effects of mental health training and clinical audit on general practitioners’ management of common mental disorders. Med J Aust, 175(Suppl), S42–S47.PubMed
go back to reference Oopik, P., Aluoja, A., Kalda, R., & Maaroos, H. I. (2006). Family doctors’ problems and motivating factors in management of depression. BMC Fam Pract, 7, 64.PubMedCentralCrossRefPubMed Oopik, P., Aluoja, A., Kalda, R., & Maaroos, H. I. (2006). Family doctors’ problems and motivating factors in management of depression. BMC Fam Pract, 7, 64.PubMedCentralCrossRefPubMed
go back to reference Patel, V., Maj, M., Flisher, A. J., De Silva, M. J., Koschorke, M., Prince, M., et al. (2010). Reducing the treatment gap for mental disorders: a WPA survey. World Psychiatry, 9(3), 169–176.PubMedCentralPubMed Patel, V., Maj, M., Flisher, A. J., De Silva, M. J., Koschorke, M., Prince, M., et al. (2010). Reducing the treatment gap for mental disorders: a WPA survey. World Psychiatry, 9(3), 169–176.PubMedCentralPubMed
go back to reference Priest, R. G., Vize, C., Roberts, A., Roberts, M., & Tylee, A. (1996). Lay people’s attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch. BMJ, 313(7061), 858–859.PubMedCentralCrossRefPubMed Priest, R. G., Vize, C., Roberts, A., Roberts, M., & Tylee, A. (1996). Lay people’s attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch. BMJ, 313(7061), 858–859.PubMedCentralCrossRefPubMed
go back to reference Richards, J. C., Ryan, P., McCabe, M. P., Groom, G., & Hickie, I. B. (2004). Barriers to the effective management of depression in general practice. Aust N Z J Psychiatry, 38(10), 795–803.CrossRefPubMed Richards, J. C., Ryan, P., McCabe, M. P., Groom, G., & Hickie, I. B. (2004). Barriers to the effective management of depression in general practice. Aust N Z J Psychiatry, 38(10), 795–803.CrossRefPubMed
go back to reference Ronalds, C., Creed, F., Stone, K., Webb, S., & Tomenson, B. (1997). Outcome of anxiety and depressive disorders in primary care. Br J Psychiatry, 171, 427–433.CrossRefPubMed Ronalds, C., Creed, F., Stone, K., Webb, S., & Tomenson, B. (1997). Outcome of anxiety and depressive disorders in primary care. Br J Psychiatry, 171, 427–433.CrossRefPubMed
go back to reference Steel, Z., McDonald, R., Silove, D., Bauman, A., Sandford, P., Herron, J., et al. (2006). Pathways to the first contact with specialist mental health care. Aust N Z J Psychiatry, 40(4), 347–354.CrossRefPubMed Steel, Z., McDonald, R., Silove, D., Bauman, A., Sandford, P., Herron, J., et al. (2006). Pathways to the first contact with specialist mental health care. Aust N Z J Psychiatry, 40(4), 347–354.CrossRefPubMed
go back to reference Tanielian, T. L., Pincus, H. A., Dietrich, A. J., Williams, J. W, Jr, Oxman, T. E., Nutting, P., et al. (2000). Referrals to psychiatrists. Assessing the communication interface between psychiatry and primary care. Psychosomatics, 41(3), 245–252.CrossRefPubMed Tanielian, T. L., Pincus, H. A., Dietrich, A. J., Williams, J. W, Jr, Oxman, T. E., Nutting, P., et al. (2000). Referrals to psychiatrists. Assessing the communication interface between psychiatry and primary care. Psychosomatics, 41(3), 245–252.CrossRefPubMed
go back to reference The Harvard Team. (1998). Hong Kong Private Practice Survey, Special Report #4, Harvard Report. The Harvard Team. (1998). Hong Kong Private Practice Survey, Special Report #4, Harvard Report.
go back to reference Tylee, A., Freeling, P., Kerry, S., & Burns, T. (1995). How does the content of consultations affect the recognition by general practitioners of major depression in women? Br J Gen Pract, 45(400), 575–578.PubMedCentralPubMed Tylee, A., Freeling, P., Kerry, S., & Burns, T. (1995). How does the content of consultations affect the recognition by general practitioners of major depression in women? Br J Gen Pract, 45(400), 575–578.PubMedCentralPubMed
go back to reference van Os, T. W., Ormel, J., van den Brink, R. H., Jenner, J. A., Van der Meer, K., Tiemens, B. G., et al. (1999). Training PCPs improves the management of depression. Gen Hosp Psychiatry, 21(3), 168–176.CrossRefPubMed van Os, T. W., Ormel, J., van den Brink, R. H., Jenner, J. A., Van der Meer, K., Tiemens, B. G., et al. (1999). Training PCPs improves the management of depression. Gen Hosp Psychiatry, 21(3), 168–176.CrossRefPubMed
go back to reference World Health Organization. (2008). Integrating mental health into primary care: a global perspective. Geneva: World Health Organization. World Health Organization. (2008). Integrating mental health into primary care: a global perspective. Geneva: World Health Organization.
go back to reference Wright, M. J., Harmon, K. D., Bowman, J. A., Lewin, T. J., & Carr, V. J. (2005). Caring for depressed patients in rural communities: general practitioners’ attitudes, needs and relationships with mental health services. Aust J Rural Health, 13(1), 21–27.CrossRefPubMed Wright, M. J., Harmon, K. D., Bowman, J. A., Lewin, T. J., & Carr, V. J. (2005). Caring for depressed patients in rural communities: general practitioners’ attitudes, needs and relationships with mental health services. Aust J Rural Health, 13(1), 21–27.CrossRefPubMed
go back to reference Younes, N., Hardy-Bayle, M. C., Falissard, B., Kovess, V., Chaillet, M. P., & Gasquet, I. (2005). Differing mental health practice among general practitioners, private psychiatrists and public psychiatrists. BMC Public Health, 5, 104.PubMedCentralCrossRefPubMed Younes, N., Hardy-Bayle, M. C., Falissard, B., Kovess, V., Chaillet, M. P., & Gasquet, I. (2005). Differing mental health practice among general practitioners, private psychiatrists and public psychiatrists. BMC Public Health, 5, 104.PubMedCentralCrossRefPubMed
go back to reference Zakroyeva, A., Goldberg, D., Gask, L., & Leese, M. (2008). Training Russian family physicians in mental health skills. Eur J Gen Pract, 14(1), 19–22.CrossRefPubMed Zakroyeva, A., Goldberg, D., Gask, L., & Leese, M. (2008). Training Russian family physicians in mental health skills. Eur J Gen Pract, 14(1), 19–22.CrossRefPubMed
Metadata
Title
Obstacles in Managing Mental Health Problems for Primary Care Physicians in Hong Kong
Authors
Kai Sing Sun
Tai Pong Lam
Kwok Fai Lam
Tak Lam Lo
Publication date
01-11-2015
Publisher
Springer US
Published in
Administration and Policy in Mental Health and Mental Health Services Research / Issue 6/2015
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-014-0605-x

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