Étude qualitative sur le ressenti des médecins généralistes de Haute-Savoie face à leur rôle et à leur place dans le parcours de soins en santé mentale

Abstract : Objective: Study the perception of general practitioners (GPs) in Haute Savoie regarding their role and place in mental health care management in 2018. Method: Qualitative study with ten GPs in Haute Savoie. Data was collected during semi-directive individual interviews, using an interview guide. The verbatim quotes were analysed using phenomenological thematic analysis. Results: Societal and personal representations of mental health influenced the interest of GPs. Their overall perspective and position as a first recourse for patients makes them identifiers of mental health issues. GPs felt more involved in managing psychological issues than psychotic issues. They had an important role in the prescription of antidepressants, antianxiety drugs, and sick leave certificates. Despite the unanimous recognition of the usefulness of psychotherapy, few doctors used it in their practices. They considered having initial training unsuitable for their daily practice. They called on psychiatrists for diagnostic and therapeutic help and in the case of limits to their competencies. GPs considered themselves to have an essential role in mental health care management but did not think they could work alone. The care network made treatment easier, but creating it seemed complex. They described their role as coordinators and filters in the network, but deplored the lack of interprofessional communication. Access to specialised care was still perceived as complicated. Faced with these difficulties, GPs suggested changes to their way of operating : decentralisation of mental health care to general medical practices, and improving local work through further developing the role of specialist nurses and promoting the importance of psychologists. Conclusion: GPS considered themselves to have an essential role and place in mental health care management. Collaborative work is essential but remains to be developed further, with the encouragement of interprofessional networking.
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Master Thesis
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Alice Ydema, Adelin Valli. Étude qualitative sur le ressenti des médecins généralistes de Haute-Savoie face à leur rôle et à leur place dans le parcours de soins en santé mentale. Médecine humaine et pathologie. 2019. ⟨dumas-02020310⟩

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