The role of mental health service ( Psychiatrists) and primary care services (GPs) in their treatment of dual diagnosis. A comparrative study.

Abstract

OBJECTIVE: This research study set out to compare two treatment services Primary Care Services (GPs) and Mental Health Services (psychiatrists) in their treatment of patients with dual diagnosis in an Irish population. DESIGN: A postal questionnaire with five sections Section I: General Questions on demographics (Q.l 3a). Section 2: Policy I Service Provision (Q.4 - 8b). Section 3: Co-ordination of care (Q.9 -15). Section 4: Policy I Assessment (Q16 - 16a). Section 5: The management of Dual Diagnosis. SUBJECTS AND SETTING: Two hundred (n=200) Dublin GPs and two hundred (n=200) Psychiatrists RESULTS: 85% of Psychiatrists compared to only 50% of the GPs stated that their definition for dual diagnosis was the same or similar to the one that had been given to them at the beginning of the study and in addition it was found that 27.7% more patients with drug and alcohol problems are likely to be treated by Psychiatrists than GPs. Thus in practice GPs are less likely than Psychiatrists to have a treatment model for dual diagnosis. It was also found that in comparison to Psychiatrists, GPs treat patients with dual diagnosis as having two separate conditions, Cohen's d 0.627. CONCLUSION: Addiction services are reluctant to accept individuals with a dual diagnosis because of their lack of mental health training. The stark findings in this study show a lack of policies and structures that need to be implemented if service providers are to start treating patients with a dual diagnosis. Lack of structures for treating dual diagnosis can account for the high percentage of re admissions for patients with dual diagnosis. From the evidence provided it is apparent that Primary care services and mental health services continue to function as two separate services.