Skip to main content
Top
Published in: BMC Primary Care 1/2009

Open Access 01-12-2009 | Research article

Variables associated with general practitioners taking on serious mental disorder patients

Authors: Marie-Josée Fleury, Jean-Marie Bamvita, Jacques Tremblay

Published in: BMC Primary Care | Issue 1/2009

Login to get access

Abstract

Background

As part of community-based initiatives to strengthen integrated care and promote patient recovery, GPs are asked to play a greater part in treating serious mental disorder (SMD) patients. All current healthcare reforms favour the reinforcement of primary care. More information on enhancing the role of GPs in mental health would benefit policymakers, especially as regards SMD patients, where little research has been published as yet. This article assesses variables associated with GPs taking on SMD patients.

Methods

The study, encompassing multiple sites, is based on a sample of 398 GPs, representative of the GP population in the Canadian province of Quebec. GPs were asked to answer a 143-item questionnaire on their socio-demographic and clinical practice profiles, patient characteristics, perceived inter-professional relationships and quality of care. Descriptive, bivariate and multivariate analyses were performed.

Results

Our data highlighted that GPs currently followed up only a minority of SMD patients on a continuous basis and far fewer for both physical and mental health problems. A linear regression model that accounts for 43% of the variance was generated. The best variables associated positively with GPs taking on SMD patients were: frequency of referrals for joint follow-up with other resources, and involvement in post-hospitalization follow-up. Conversely, lack of expertise in mental health (related in our model to frequency of mental disorder patient transfer due to insufficient mental health training) is associated with a lower incidence of GPs taking on patients.

Conclusion

As advocated in current healthcare reforms, our study confirms the need to promote greater GP involvement in integrated care models and enhance their training in mental health – thereby helping to reverse the trend among GPs of transferring SMD patients to specialized care. Patients with stable SMDs ought to have the same care access as the general population.
Literature
1.
go back to reference Horner D, Asher K: General practitioners and mental health staff sharing patient care: working model. Australasian Psychiatry. 2005, 13 (2): 176-80. 10.1111/j.1440-1665.2005.02184.x.CrossRefPubMed Horner D, Asher K: General practitioners and mental health staff sharing patient care: working model. Australasian Psychiatry. 2005, 13 (2): 176-80. 10.1111/j.1440-1665.2005.02184.x.CrossRefPubMed
2.
go back to reference WHO/Wonca: Joint report: Integrating mental health into primary care – a global perspective. 2008, Geneva Switzerland: WHO publication data WHO/Wonca: Joint report: Integrating mental health into primary care – a global perspective. 2008, Geneva Switzerland: WHO publication data
3.
go back to reference Meadow GN: Establishing a collaborative service model for primary mental health care. Med J Aust. 1998, 168 (4): 162-5. Meadow GN: Establishing a collaborative service model for primary mental health care. Med J Aust. 1998, 168 (4): 162-5.
4.
go back to reference Doggett J: A new approach to primary care for Australia. 2007, Sydney, NSW: Centre for policy development, Contract No.: Document Number|. Doggett J: A new approach to primary care for Australia. 2007, Sydney, NSW: Centre for policy development, Contract No.: Document Number|.
5.
go back to reference Starfield B, Shi L, Macinko J: Contribution of primary care to health systems and health. The Milbank quarterly. 2005, 83 (3): 457-502. 10.1111/j.1468-0009.2005.00409.x.CrossRefPubMedPubMedCentral Starfield B, Shi L, Macinko J: Contribution of primary care to health systems and health. The Milbank quarterly. 2005, 83 (3): 457-502. 10.1111/j.1468-0009.2005.00409.x.CrossRefPubMedPubMedCentral
6.
go back to reference Engstrom S, Foldevi M, Borgquist L: Is general practice effective? A systematic literature review. Scandinavian journal of primary health care. 2001, 19 (2): 131-44. 10.1080/028134301750235394.CrossRefPubMed Engstrom S, Foldevi M, Borgquist L: Is general practice effective? A systematic literature review. Scandinavian journal of primary health care. 2001, 19 (2): 131-44. 10.1080/028134301750235394.CrossRefPubMed
7.
8.
go back to reference Anderson RL, Lewis DA: Clinical characteristics and service use of persons with mental illness living in an intermediate care facility. Psychiatric Services. 1999, 50 (10): 1341-5.CrossRefPubMed Anderson RL, Lewis DA: Clinical characteristics and service use of persons with mental illness living in an intermediate care facility. Psychiatric Services. 1999, 50 (10): 1341-5.CrossRefPubMed
9.
go back to reference Bond GR, Drake RE, Becker DR, Mueser KT: Effectiveness of psychiatric rehabilitation approaches for employment of people with severe mental illness. Journal of Disability Policy Studies. 1999, 10 (1): 18-52. Bond GR, Drake RE, Becker DR, Mueser KT: Effectiveness of psychiatric rehabilitation approaches for employment of people with severe mental illness. Journal of Disability Policy Studies. 1999, 10 (1): 18-52.
10.
go back to reference Anthony WA: Integrating Psychiatric Rehabilitation into Managed Care. Psychiatric Rehabilitation Journal. 1995, Fall, 10 (4): 1-12. Anthony WA: Integrating Psychiatric Rehabilitation into Managed Care. Psychiatric Rehabilitation Journal. 1995, Fall, 10 (4): 1-12.
11.
go back to reference Crews C, Batal H, Elasy T, Casper E, Mehler PS: Primary care for those with severe and persistent mental illness. West J Med. 1998, 169 (4): 245-50.PubMedPubMedCentral Crews C, Batal H, Elasy T, Casper E, Mehler PS: Primary care for those with severe and persistent mental illness. West J Med. 1998, 169 (4): 245-50.PubMedPubMedCentral
12.
go back to reference Williams J, Gerrity M, Holsinger T, Dobscha S, Gaynes B, Dietrich A: Systematic review of multifaceted interventions to improve depression care. General Hospital Psychiatry. 2007, 29: 91-116. 10.1016/j.genhosppsych.2006.12.003.CrossRefPubMed Williams J, Gerrity M, Holsinger T, Dobscha S, Gaynes B, Dietrich A: Systematic review of multifaceted interventions to improve depression care. General Hospital Psychiatry. 2007, 29: 91-116. 10.1016/j.genhosppsych.2006.12.003.CrossRefPubMed
13.
go back to reference American Academy of Pediatrics: Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Pediatrics. 2002, 110: 184-186. 10.1542/peds.110.1.184.CrossRef American Academy of Pediatrics: Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Pediatrics. 2002, 110: 184-186. 10.1542/peds.110.1.184.CrossRef
14.
go back to reference Craven MA, Bland R: Better practices in collaborative mental health care: an analysis of the evidence base. Can J Psychiatry. 2006, 51 (6 Suppl 1): 7S-72S.PubMed Craven MA, Bland R: Better practices in collaborative mental health care: an analysis of the evidence base. Can J Psychiatry. 2006, 51 (6 Suppl 1): 7S-72S.PubMed
15.
go back to reference Fleury MJ: Models of Integrated Service Networks and Key Conditions for their Operationalization. International Journal of Integrated Care. 2005, 5: 1-14.CrossRef Fleury MJ: Models of Integrated Service Networks and Key Conditions for their Operationalization. International Journal of Integrated Care. 2005, 5: 1-14.CrossRef
16.
go back to reference Fleury MJ: Integrated service networks: the Quebec case. Health Serv Manage Res. 2006, 19 (3): 153-65. 10.1258/095148406777888080.CrossRefPubMed Fleury MJ: Integrated service networks: the Quebec case. Health Serv Manage Res. 2006, 19 (3): 153-65. 10.1258/095148406777888080.CrossRefPubMed
17.
go back to reference Fleury MJ, Mercier C: Integrated local networks as a model for organizing mental health services. Administration and Policy in Mental Health. 2002, 30 (55–73): Fleury MJ, Mercier C: Integrated local networks as a model for organizing mental health services. Administration and Policy in Mental Health. 2002, 30 (55–73):
18.
go back to reference Randolph F, Blasinsky M, Leginski W, Buckley Parker L, Goldman HH: Creating Integrated Service Systems for Homeless Persons with Mental Illness: The ACCESS Program. Psychiatric Services. 1997, 48 (3): 369-73.CrossRefPubMed Randolph F, Blasinsky M, Leginski W, Buckley Parker L, Goldman HH: Creating Integrated Service Systems for Homeless Persons with Mental Illness: The ACCESS Program. Psychiatric Services. 1997, 48 (3): 369-73.CrossRefPubMed
19.
go back to reference Lester H, Tritter JQ, Sorohan H: Patients' and health professionals' views on primary care for people with serious mental illness: focus group study. Bmj. 2005, 330 (7500): 1122-10.1136/bmj.38440.418426.8F.CrossRefPubMedPubMedCentral Lester H, Tritter JQ, Sorohan H: Patients' and health professionals' views on primary care for people with serious mental illness: focus group study. Bmj. 2005, 330 (7500): 1122-10.1136/bmj.38440.418426.8F.CrossRefPubMedPubMedCentral
20.
go back to reference Burns T, Kendrick T: Care of long-term mentally ill patients by British general practitioners. Psychiatr Serv. 1997, 48: 1586-8.CrossRefPubMed Burns T, Kendrick T: Care of long-term mentally ill patients by British general practitioners. Psychiatr Serv. 1997, 48: 1586-8.CrossRefPubMed
21.
go back to reference Rothman AA, Wagner EH: Chronic Illness Management: What Is the Role of Primary Care?. Annals of Internal Medicine. 2003, 138 (3): 256-62.CrossRefPubMed Rothman AA, Wagner EH: Chronic Illness Management: What Is the Role of Primary Care?. Annals of Internal Medicine. 2003, 138 (3): 256-62.CrossRefPubMed
23.
go back to reference Lockhart C: Collaboration and referral practices of general practitioners and community mental health workers in rural and remote Australia. Journal Compilation. 2006, 14: 29-32. Lockhart C: Collaboration and referral practices of general practitioners and community mental health workers in rural and remote Australia. Journal Compilation. 2006, 14: 29-32.
24.
go back to reference Bambling M, Kavanagh D, Lewis G, King R, King D, Sturk H, Turpin M, Gallois C, Bartlett H: Challenges faced by general practitioners and allied mental health services in providing mental health services in rural Queensland. Australian Journal Rural Health. 2007, 15: 126-30. 10.1111/j.1440-1584.2007.00866.x.CrossRef Bambling M, Kavanagh D, Lewis G, King R, King D, Sturk H, Turpin M, Gallois C, Bartlett H: Challenges faced by general practitioners and allied mental health services in providing mental health services in rural Queensland. Australian Journal Rural Health. 2007, 15: 126-30. 10.1111/j.1440-1584.2007.00866.x.CrossRef
25.
go back to reference Gagné M-A: Avancement des objectifs des soins de santé mentale axés sur la collaboration. 2005, Mississauga, Ontario: Initiative canadienne de collaboration en santé mentale, Contract No.: Document Number|. Gagné M-A: Avancement des objectifs des soins de santé mentale axés sur la collaboration. 2005, Mississauga, Ontario: Initiative canadienne de collaboration en santé mentale, Contract No.: Document Number|.
26.
go back to reference Watson DE, Heppner P, Roos NP, Reid RJ, Katz A: Population-based use of mental health services and patterns of delivery among family physicians, 1992 to 2001. Canadian Journal of Psychiatry. 2005, 50 (7): 398-406.PubMed Watson DE, Heppner P, Roos NP, Reid RJ, Katz A: Population-based use of mental health services and patterns of delivery among family physicians, 1992 to 2001. Canadian Journal of Psychiatry. 2005, 50 (7): 398-406.PubMed
27.
go back to reference Keks N, Altson B, Sacks T: Collaboration between general practice and community psychiatric services for people with chronic mental illness. 2001, MJA Practice Essentials Mental Health, Sidney: Australasian Medical Publishing Keks N, Altson B, Sacks T: Collaboration between general practice and community psychiatric services for people with chronic mental illness. 2001, MJA Practice Essentials Mental Health, Sidney: Australasian Medical Publishing
28.
go back to reference Wright M, Harmon KD, Bowman JA, Lewin TJ, Carr VJ: Caring for depressed patients in rural communities: general practitioners' attitudes, needs and relationships with mental health services. Australian Journal Rural Health. 2005, 13: 21-7. 10.1111/j.1440-1854.2004.00641.x.CrossRef Wright M, Harmon KD, Bowman JA, Lewin TJ, Carr VJ: Caring for depressed patients in rural communities: general practitioners' attitudes, needs and relationships with mental health services. Australian Journal Rural Health. 2005, 13: 21-7. 10.1111/j.1440-1854.2004.00641.x.CrossRef
29.
go back to reference Kushner K, Diamond R, Beasley jW, Mundt M, Plane MB, Robbins K: Primary care physicians' experience with mental health consultation. Psychiatr Serv. 2001, 52 (6): 838-40. 10.1176/appi.ps.52.6.838.CrossRefPubMed Kushner K, Diamond R, Beasley jW, Mundt M, Plane MB, Robbins K: Primary care physicians' experience with mental health consultation. Psychiatr Serv. 2001, 52 (6): 838-40. 10.1176/appi.ps.52.6.838.CrossRefPubMed
30.
go back to reference Ministère de la Santé et des Services sociaux (MSSS): Plan d'action en santé mentale 2005–2010. La force des liens. Québec. 2005, Contract No.: Document Number|. Ministère de la Santé et des Services sociaux (MSSS): Plan d'action en santé mentale 2005–2010. La force des liens. Québec. 2005, Contract No.: Document Number|.
31.
go back to reference Brown JB, Lent B, Takhar J, Bishop J: Caring for seriously mentally ill patients. Can Fam Physician. 2002, 48 (5): 915-22.PubMedPubMedCentral Brown JB, Lent B, Takhar J, Bishop J: Caring for seriously mentally ill patients. Can Fam Physician. 2002, 48 (5): 915-22.PubMedPubMedCentral
32.
go back to reference Stip E, Boyer R, Sepehry AA, Rodriguez JP, Umbricht D, Tempier A, Simon AE: On the front line: survey on shared responsibility. General practitioners and schizophrenia. Sante Ment Que. 2007, Spring, 32 (1): 281-97.CrossRefPubMed Stip E, Boyer R, Sepehry AA, Rodriguez JP, Umbricht D, Tempier A, Simon AE: On the front line: survey on shared responsibility. General practitioners and schizophrenia. Sante Ment Que. 2007, Spring, 32 (1): 281-97.CrossRefPubMed
33.
go back to reference Gask L, Rogers A, Campbell S, Sheaff R: Beyond the Limits of Clinical Governance? The Case of Mental Health in English Primary Care. BMC health services research. 2008, 8: 1-10. 10.1186/1472-6963-8-1.CrossRef Gask L, Rogers A, Campbell S, Sheaff R: Beyond the Limits of Clinical Governance? The Case of Mental Health in English Primary Care. BMC health services research. 2008, 8: 1-10. 10.1186/1472-6963-8-1.CrossRef
34.
go back to reference Savard I, Rodrigue J: Des omnipraticiens à la grandeur du Québec. Évolution des effectifs et des profils de pratique. Données de 1996–1997 à 2005–2006. 2007, Direction de la planification et de la régionalisation – FMOQ, Contract No.: Document Number|. Savard I, Rodrigue J: Des omnipraticiens à la grandeur du Québec. Évolution des effectifs et des profils de pratique. Données de 1996–1997 à 2005–2006. 2007, Direction de la planification et de la régionalisation – FMOQ, Contract No.: Document Number|.
35.
go back to reference Fleury M, Bamvita JM, Farand L, Tremblay J: Variables Associated with GPs Taking on Patients with Common Mental Disorders. Mental Health in Family Medicine. 2009, 5 (3): Fleury M, Bamvita JM, Farand L, Tremblay J: Variables Associated with GPs Taking on Patients with Common Mental Disorders. Mental Health in Family Medicine. 2009, 5 (3):
36.
go back to reference Savard I, Gaucher S, Rodrigue J, Dubé R, Villeneuve P: Les Médecins de famille de nouveau sous la loupe. Le Médecin du Québec. [sondage sur la transformation du réseau et les conditions d'exercice et de rémunération]. 2005, 40 (1): 105-16. Savard I, Gaucher S, Rodrigue J, Dubé R, Villeneuve P: Les Médecins de famille de nouveau sous la loupe. Le Médecin du Québec. [sondage sur la transformation du réseau et les conditions d'exercice et de rémunération]. 2005, 40 (1): 105-16.
37.
go back to reference Ouadahi J, Lesage A, Fleury MJ: Rôle des médecins de famille: Volet données administratives 2002 et 2006, Québec. 2009, Douglas Institut Universitaire en santé mentale Ouadahi J, Lesage A, Fleury MJ: Rôle des médecins de famille: Volet données administratives 2002 et 2006, Québec. 2009, Douglas Institut Universitaire en santé mentale
38.
go back to reference Pong RW: Répartition géographique des médecins au Canada: au-delà du nombre et du lieu. 2005, Institut canadien d'information sur la santé; Ottawa, 2- Pong RW: Répartition géographique des médecins au Canada: au-delà du nombre et du lieu. 2005, Institut canadien d'information sur la santé; Ottawa, 2-
39.
go back to reference Walters P, Tylee A, Goldberg D: Psychiatry in Primary Care. Edited by: Murray RMKK, McGuffin P, Wessely S, Castle DJ. 2008, Essential Psychiatry: Cambridge Medicine, 479-97. Walters P, Tylee A, Goldberg D: Psychiatry in Primary Care. Edited by: Murray RMKK, McGuffin P, Wessely S, Castle DJ. 2008, Essential Psychiatry: Cambridge Medicine, 479-97.
40.
go back to reference Ansseau M, Dierick M, Buntinkx F, Cnockaert P, De Smedt J, Haute Van Den M, Mijnsbrugge Vander D: High prevalence of mental disorders in primary care. Journal of affective disorders. 2004, 78 (1): 49-55. 10.1016/S0165-0327(02)00219-7.CrossRefPubMed Ansseau M, Dierick M, Buntinkx F, Cnockaert P, De Smedt J, Haute Van Den M, Mijnsbrugge Vander D: High prevalence of mental disorders in primary care. Journal of affective disorders. 2004, 78 (1): 49-55. 10.1016/S0165-0327(02)00219-7.CrossRefPubMed
41.
go back to reference Berardi D, Menchetti M, Cevenini N, Scaini S, Versari M, De Ronchi D: Increased recognition of depression in primary care. Comparison between primary-care physician and ICD-10 diagnosis of depression. Psychother Psychosom. 2005, 74 (4): 225-30. 10.1159/000085146.CrossRefPubMed Berardi D, Menchetti M, Cevenini N, Scaini S, Versari M, De Ronchi D: Increased recognition of depression in primary care. Comparison between primary-care physician and ICD-10 diagnosis of depression. Psychother Psychosom. 2005, 74 (4): 225-30. 10.1159/000085146.CrossRefPubMed
42.
go back to reference Rittenhouse D, Casalino LP, Gillies RR, Shortell SM, Lau B: Measuring The Medical Home Infrastructure In Large Medical groups. Medical Home (Health Affairs). 2008, 27: 1246-58. Rittenhouse D, Casalino LP, Gillies RR, Shortell SM, Lau B: Measuring The Medical Home Infrastructure In Large Medical groups. Medical Home (Health Affairs). 2008, 27: 1246-58.
43.
go back to reference Bindman J, Johnson S, Szmukler G, Wright S, Kuipers E, Thornicroft G, et al: Continuity of Care and Clinical Outcome: A Prospective Cohort Study. Social Psychiatry & Psychiatric Epidemiology. 2000, 35 (6): 242-7. 10.1007/s001270050234.CrossRef Bindman J, Johnson S, Szmukler G, Wright S, Kuipers E, Thornicroft G, et al: Continuity of Care and Clinical Outcome: A Prospective Cohort Study. Social Psychiatry & Psychiatric Epidemiology. 2000, 35 (6): 242-7. 10.1007/s001270050234.CrossRef
44.
go back to reference Thornicroft G, Tansella M: The Mental Health Matrix A manual to improve services. 1999, New York: Cambridge University PressCrossRef Thornicroft G, Tansella M: The Mental Health Matrix A manual to improve services. 1999, New York: Cambridge University PressCrossRef
45.
go back to reference Carr VJ, Lewin TJ, Barnard RE, Walton JM, Allen JL, Constable PM, Chapman JL: Attitudes and roles of general practitioners in the treatment of schizophrenia compared with community mental health staff and patients. Soc Psychiatry Psychiatr Epidemiol. 2004, 39 (1): 78-84. 10.1007/s00127-004-0703-2.CrossRefPubMed Carr VJ, Lewin TJ, Barnard RE, Walton JM, Allen JL, Constable PM, Chapman JL: Attitudes and roles of general practitioners in the treatment of schizophrenia compared with community mental health staff and patients. Soc Psychiatry Psychiatr Epidemiol. 2004, 39 (1): 78-84. 10.1007/s00127-004-0703-2.CrossRefPubMed
46.
go back to reference Kisely S, Duerden D, Shaddick S, Jayabarathan A: Collaboration between primary care and psychiatric services. 2006, Le médecin de famille canadien, 876-7. Kisely S, Duerden D, Shaddick S, Jayabarathan A: Collaboration between primary care and psychiatric services. 2006, Le médecin de famille canadien, 876-7.
47.
go back to reference McCrone P, Leese M, Thornicroft G, Schene A, Knudsen HC, Vazquez-Barquero JL, et al: Reliability of the Camberwell Assessment of Need-European Version. EPSILON Study 6. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs. British Journal of Psychiatry. 2000, 39: s34-40. 10.1192/bjp.177.39.s34.CrossRefPubMed McCrone P, Leese M, Thornicroft G, Schene A, Knudsen HC, Vazquez-Barquero JL, et al: Reliability of the Camberwell Assessment of Need-European Version. EPSILON Study 6. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs. British Journal of Psychiatry. 2000, 39: s34-40. 10.1192/bjp.177.39.s34.CrossRefPubMed
48.
go back to reference Fleury M, Grenier G, Caron J, Lesage A: Patient's Report of Help Provided by Relatives and Services to Meet Their Needs. Community Ment Health J. 2008, 44: 271-81. 10.1007/s10597-008-9127-x.CrossRefPubMed Fleury M, Grenier G, Caron J, Lesage A: Patient's Report of Help Provided by Relatives and Services to Meet Their Needs. Community Ment Health J. 2008, 44: 271-81. 10.1007/s10597-008-9127-x.CrossRefPubMed
49.
go back to reference Balanchandra K: How bipolar disorders are managed in family practice. Canadian Family Physician. 2005, 51 (4): 535-7. Balanchandra K: How bipolar disorders are managed in family practice. Canadian Family Physician. 2005, 51 (4): 535-7.
50.
go back to reference Iacovides A, Siamouli M: Comorbid mental and somatic disorders: an epidemiological perspective. Curr Opin Psychiatry. 2008, 21 (4): 417-21. 10.1097/YCO.0b013e328303ba42.CrossRefPubMed Iacovides A, Siamouli M: Comorbid mental and somatic disorders: an epidemiological perspective. Curr Opin Psychiatry. 2008, 21 (4): 417-21. 10.1097/YCO.0b013e328303ba42.CrossRefPubMed
51.
go back to reference Gentil V: Introduction to bipolar disorder and comorbid conditions. The Journal of clinical psychiatry. 2008, 69 (1): Gentil V: Introduction to bipolar disorder and comorbid conditions. The Journal of clinical psychiatry. 2008, 69 (1):
52.
go back to reference Jones B, Gallagher BJ, Pisa AM, McFalls JA: Social class, family history and type of schizophrenia. Psychiatry Res. 2008, 159 (30): 127-32. 10.1016/j.psychres.2007.08.006.CrossRefPubMed Jones B, Gallagher BJ, Pisa AM, McFalls JA: Social class, family history and type of schizophrenia. Psychiatry Res. 2008, 159 (30): 127-32. 10.1016/j.psychres.2007.08.006.CrossRefPubMed
53.
go back to reference Turner T, De Sorkin A: Sharing psychiatric care with primary care physicians: the Toronto Doctors Hospital experience. Can J Psychiatry. 1997, 42: 950-4.PubMed Turner T, De Sorkin A: Sharing psychiatric care with primary care physicians: the Toronto Doctors Hospital experience. Can J Psychiatry. 1997, 42: 950-4.PubMed
54.
go back to reference Lafleur P-A: Le métier de psychiatre au Québec. L'information psychiatrique. 2003, 79 (6): 503-10. Lafleur P-A: Le métier de psychiatre au Québec. L'information psychiatrique. 2003, 79 (6): 503-10.
55.
go back to reference Le Collège des Médecins de Famille du Canada: . 2004, Sondage nationale 2004 auprès des médecins: Association Médicale Canadienne, Contract No.: Document Number|. Le Collège des Médecins de Famille du Canada: . 2004, Sondage nationale 2004 auprès des médecins: Association Médicale Canadienne, Contract No.: Document Number|.
56.
go back to reference Cook S, Howe A: Engaging people with enduring psychotic conditions in primary mental health care and occupational therapy. British Journal of Occupational Therapy. 2003, 66: 236-46.CrossRef Cook S, Howe A: Engaging people with enduring psychotic conditions in primary mental health care and occupational therapy. British Journal of Occupational Therapy. 2003, 66: 236-46.CrossRef
Metadata
Title
Variables associated with general practitioners taking on serious mental disorder patients
Authors
Marie-Josée Fleury
Jean-Marie Bamvita
Jacques Tremblay
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2009
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-10-41

Other articles of this Issue 1/2009

BMC Primary Care 1/2009 Go to the issue