Integration of Mental Health in Primary Care: the use of instruments for screening and evaluation
Year: 2019
Type: article
Abstract: Introduction: According to the Portuguese Directorate-General of Health (DGS, 2017, p. 13), “Portugal is one of the European countries with the highest prevalence of mental health disorders, nd a significant number of these people do not have access to mental health care". Although the integration of mental health in PHC is essential to change this alarming situation, this seems to be a long and difficult process, requiring other short-term solutions. Objectives: This study aimed to verify the difficulties in the detection of mental disorders in PHC, with regards to the resources and time between symptoms and diagnosis, and develop a screening protocol to facilitate the proper referral of these cases. Methods: 1) Analysis of the WHO, European Commission and DGS guidelines to verify the difficulties and the goals for providing mental health services in PHC. 2) Semi-structured interviews with 50 patients in the Coimbra University Hospital Centre to identify a) the time between symptoms and diagnosis; and b) indicators for the referral to mental health services. 3) Development of a protocol to be implemented as a preliminary screening of mental disorders in PHC. The abovementioned studies and a previous review on evaluation instruments were the basis for this proposal conception. Results: The early detection of mental disorders is essential for patients’ adherence to treatment, reflecting in global health and the costs of health services, data corroborated by field survey. Regarding the Portuguese context, the screening protocol considered the most common symptoms and social aspects of this population, as well as the instruments psychometric proprieties, being composed of a clinical questionnaire and three instruments: PHQ-15, SF-20 and BSI. Conclusion: This protocol evaluates the physical and psychological symptoms commonly observed in the health services in Portugal, facilitating the early diagnosis and the proper referral of the PHC patients to mental health services.
Authors: J Becker, S Ferreira, R Paixão, M Quartilho
Institution: University of Coimbra
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2941455232