Percepción de la demanda y necesidades de formación en salud mental de los médicos de atención primaria

Abstract

Objective. To know the opinion of the primary health care (PHC) physicians on the assistance demand in mental health (MH), their training necessities and their attitudes about this disorders. Design. Observational and transversal study. Setting. Primary care. Participants. The subjects of the study were PHC physicians. From a total of 1191 PHC physicians in Castilla-La Mancha region, 301 were selected by random stratified sampling. Main measurements. A self-complimented questionnaire was elaborated, being identified the following variables: professional and sociodemographics characteristics, their perceived demands of MH problems, perceived difficulties in resolution, training in MH, knowledge about specialized resources and their attitudes about mental disorders. Results. 63.5% (95% confidence interval [CI], 57.6-69.4) considered that the mental problems are related with, at least, 20% of the consultations. Very frequent consulted problems were: anxiety disorders (75.9%), affective disorders (73.5%), and somatoform disorders (40.5%). 63.6% (95% CI; 57.8-69.6) considered to have enough information about specialized resources. About attitudes, 43.7% (95% CI; 37.7-49.8) said the PHC physicians cannot be taken charge of the existent demand. This opinion as significantly more frequents in physicians with more patient assigned, more assistance pressure, without postgraduate assistance formation (Spanish MIR system), with less perceived demand, without training in MH and worse knowledge of the specialized resources. Conclusions. In opinion of most of the physicians the mental disorders are related with, at least, 1 of each 5 consultations. A high proportion considers that the teams of PHC cannot be taken charge of the existent demand, mainly when it is high the assistance pressure. Most says that more specific training should exist in MH and more coordination with the specialized services.