Experience of an outpatient interprofessional collaboration between general practitioner and psychiatrist: a qualitative study in a French community health center

Sophie Giraudier, Thibaut Colomb, Shérazade Kinouani

Keywords: Interprofessional collaboration; General practitioner; Psychiatrist; Qualitative study

Background:

Collaboration between general practitioners (GP) and mental health caregivers is described as difficult in France. An outpatient collaborative experience between GPs and a private psychiatrist was tested within a rural community health center (CHC) in a French southwest area between 2018 and 2022. We collected patients' opinions about this experience.

Research questions:

The main objective of our research was to explore the meaning given by the CHC patients to a collaboration between GPs and psychiatrist.

Method:

A qualitative study was carried out between May 2022 and July 2023 using semi-structured individual interviews. The initial guide was drafted by the research team based on the literature and then modified as interviews were conducted, and new hypotheses emerged. A theoretical purposive sample of 10 patients was obtained based on following criteria: age, sex, current psychiatric follow-up, meeting with the psychiatrist of the experience and the alternative medicine use. The data analysis was inspired by the Grounded Theory Method.

Results:

Patients perceived the organization of French mental healthcare system as failing. They proposed the reorganization of outpatient mental healthcare around the GP-psychiatrist pair. Colocation of GP and psychiatrist within the CHC as well as their better interprofessional communication contributed to safe and close care. However, this seemed insufficient for a lasting and quality collaboration. Patients suggested as ways to improve this collaborative experience: a better consideration of their experiential knowledge, the increase in flexibility and diversity of mental health care delivered.

Conclusions:

Even if our results were difficult to extrapolate to other contexts, this qualitative study reflected the patients’ point of view - rarely heard in France on this topic. They expected better mental health care, guaranteed by their proximity, flexibility, and diversity under the orchestration of the GP-psychiatrist pair.

Points for discussion:

Is the outpatient mental health care system perceived as failing in other European countries?

Is a collaboration involving the intervention of mental health caregivers within primary care structures more usual in other European countries?

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