Does Postgraduate Training in Community Mental Health Make a Difference to Primary Care Physicians’ Attitudes to Depression and Schizophrenia?

Abstract

This study investigated the differences in attitudes towards mental health patients between primary care physicians (PCPs) who have received postgraduate training in community mental health and those who have not. A questionnaire regarding the PCPs’ attitudes towards mental health care in general, and specifically on depression and schizophrenia, was designed to compare the attitudes between the PCPs with postgraduate training in community mental health (CMH group) and those without (non-CMH group). Besides having greater confidence in management, PCPs in the CMH group had less stigmatizing opinions towards the mental health patients than those in the non-CMH group. Differences between the two groups were mostly shown in the case for depression but not for schizophrenia. The proportion of PCPs who liked to have depressed patients on their practice list was significantly higher in the CMH group (94 vs 71 %), and their satisfaction rate in looking after depressed patients was also significantly higher than the non-CMH group (87 vs 59 %).

Appendices

Appendix 1

The training curriculum

	Seminar	Clinical attachment
Study period	September–January Once a week on weekday afternoon	January–June Once a week on weekday afternoon
Content	Designed to enrich students with theoretical and update knowledge of common psychological problems with specific reference to their diagnosis and management Twenty seminars on topics related to common psychological problems and psychotherapy:  The seminars adopt a problem orientated approach. A family physician with special interest in psychological problems pairs up with a psychiatrist to conduct the seminars	Designed to equip students with practical training in interviewing and management skills of patients with common psychological problems Eight case discussion sessions:  Students are divided into small groups to present their clinical cases to their specialist tutors for discussion and clinical management Five clinical training sessions in psychotherapy:  Students are attached to clinical units at participating hospitals for psychotherapy training Seven clinical teaching sessions by specialist clinicians:  Students are attached to psychiatric and primary care outpatient clinics and rehabilitation facilities for their clinical training
Assessment	Case commentary and written examination	Clinical examination

Appendix 2

Case Vignette of Schizophrenia

Patient Y is 20 years old. You have known Y for 1 year, who visited your clinic twice for common cold. This time Y comes with mother. Over the last few weeks Y has trouble sleeping nearly every night. Y complains that the neighbour always makes noises at night to disturb Y. Y has also mentioned the neighbour has spied upon Y. Y’s mother has heard Y shouting and arguing in bedroom alone, as if someone else is there. It appears that Y may suffer from symptoms of schizophrenia.

Case Vignette of Depression

Patient Z is 20 years old. You have known Z for 1 year, who visited your clinic twice for common cold. This time Z comes with mother. Over the last few weeks Z has trouble sleeping nearly every night, even though Z is tired all the time. Z has no appetite and has lost weight. Z has been feeling unusually sad, cannot concentrate and puts off making decisions. It appears that Z may suffer from symptoms of depression.