Difficult-to-Treat-Depression and GPs’ Role: Perceptions of Psychologists

Abstract

Introduction: Since the\rAustralian Government introduced the “Better Access to Mental Health Services”\rprogram in 2006, psychiatrists, psychologists and general practitioners (GPs)\rhave become increasingly involved in service provision for people seeking help\rwith mental health problems. The aim of this research was to a) explore\rpsychologists’ perceptions of difficult to treat depression (DTTD) and b)\rexplore what they thought about the GPs’ role in managing these patient given\rthat most patients are referred to psychologist by GPs. Methods: A previously\rdeveloped semi-structured interview schedule comprising six questions was used.\rSeven psychologists participated in a focus group held in Melbourne. Data were\ranalysed using the framework method. Findings, including Discussion: While\rpsychologists understood the term DTTD it was suggested that using different\rterms may limit understanding between health professionals. Rather than\rdiagnosing, psychologists were more likely to conduct further assessment\rcontextually to confirm GPs’ diagnosis. Communication with GPs was important,\rparticularly when managing “long-term” and suicidal patients. Management included\rcognitive and behavioural interventions and referring to other mental health\rservices, psychiatrists and/or other allied health professionals. Referral to\rpsychiatrists could be difficult because of limited availability and for some\rpatients, prohibitive costs. Although psychologists discussed\rnon-pharmacological and/or complementary treatment options with patients, they\rwere more likely to rely on GPs to discuss/prescribe these options. Conclusion:\rWhile generalisability may be limited, this study is the first to document some\runderstanding of psychologists perceptions of DTTD and the importance of GPs\rand other health professionals’ role in managing this patient cohort.