Improving Access to Psychiatric Care for Patients in Primary Care
Improving Access to Psychiatric Care for Patients in Primary Care
Getting a consultation with a psychiatrist within an appropriate time is one of the main
 issues reported by general practitioners (GP) for patients suffering from mental disorders in
 primary care. Consultation liaison in psychiatry is a system focused on general
 medicine-psychiatry collaboration. The aim of the present study is to evaluate the impact of
 the consultation-liaison on the adequacy of the access time to a psychiatric consultation
 according to the degree of urgency evaluated by the GP.
Faced with the saturation of the psychiatric care system, who recognizes the key role of the
 GP in mental health. Three-quarters of prescriptions for antidepressants and anxiolytics are
 performed by GPs, but less than one in four people with depression have been diagnosed and
 treated appropriately. The GPs describe difficulties in accessing psychiatric professionals
 and in particular to obtain a quick consultation with a psychiatrist. In different countries,
 psychiatric consultation-liaison (CL), centered on the collaboration of general medicine and
 psychiatry, have emerged. Two meta-analyzes and a Cochrane review were conducted on CL but no
 clinical trials were conducted in France. CL seems to improve patients' health at 3 months as
 well as their satisfaction and adherence to care. Results regarding the improvement of
 prescriptions from GP are encouraging. Better clinical trials are being requested and a need
 for medico-economic studies is also identified.

 In France, a psychiatry CL was born in Toulouse in 2017, the "DSPP". The present study plans
 a 2 groups randomized clinical trial, one group of GPs having access to DSPP, the other not.
 For a period of 3 months, the GPs propose to any patient, for whom they want a psychiatric
 consultation, to participate in the study and address him/her to a psychiatrist. The DSPP is
 an evaluation center without long-term patient follow-up. Only patient referred by his/her GP
 can get into the DSPP.
Inclusion Criteria:

 -  15 years patient or older:

 -  presenting mental suffering or a frequent or severe mental disorder

 -  having consulted his GP who ask for psychiatric consultation

 -  having given its consent for the use of its medico-administrative data

 -  affiliated with the general health insurance scheme

 -  of which the GP is from Haute Garonne and is voluntary to participate in the study

 -  Free, informed and written consent signed by the participant and the investigator (at
 the latest on the day of inclusion and before any examination required by the
 research) and by one of the parents for minor participants

 Exclusion Criteria:

 -  Patient with ongoing psychiatric follow-up

 -  Patient unable to answer questionnaires (unable to read or write)

 -  Patients receiving a measure of legal protection