The collaborative care model in mental health care is an essential pillar of mental health care. In the United States, many primary care physicians and psychiatrists refer patients with mental illnesses to religious mental health providers (Lawrence et al., 2014) as a part of integrated care of mental illness. Primary care physicians and practitioners of various medical disciplines are the first contact points for a significant portion of patients with psychiatric illnesses.
In this study, Nearly 98%general medical practitioners dealing patients with psychiatric illness deal with psychiatric illness, out of which nearly 30% treat the patient for psychiatric problems. Chatterjee et al. (1977) reported a referral rate of 2.64% among the out-patients compared to 0.06% by Jindal et al. Most studies quote about 60% of referrals from general medicine and 14% from surgery and surgical super-specialties.
Psychological factors had an aetiological role to play in less than 20% of the physical illness. Psychological factors play an essential role in the genesis and treatment of many physical illnesses, especially psychosomatic disorders (Kalplan & Sadock 1991). A study done by, Chadda et al. found most of the clinicians did not think psychological factors to be of much importance in physical illness genesis. (12)in contrast to our study, we found more than 90%practitioner believe that psychological factors can affect the course and outcome of medical disorders. Almost all doctors agreed that psychological factors are important in physical illness (K. Nauta 2019). similarly, in our study, more than 90% of practitioners believe that psychological factors can affect the course and outcome of medical disorder similar finding of Morgan et al.'s study, most physicians and surgeons of a hospital in London believed that psychological factors could affect the prognosis of medical diseases and these factors must be assessed routinely. Most of the physicians recognized social and psychological aspects as essential factors of the diseases. The majority of physicians believed that the presence of CL psychiatrists in ward rounds and morning reports is also necessary, and psychiatric consultation is beneficial for the management of surgical patients and dealing with substance-dependent patients. The role of psychiatric disorders is, for example, well-known as comorbid conditions able to affect the course of CPD with many sequelae (Daré et al., 2019).
A majority – of G.P.s found it easier to start prescribing psychotropic drugs than to stop (Svensson etal2019). Similarly, 48% of all participants agree that they should be able to prescribe psychotropic drugs (Nauta 2019) in our study, more than 42.62%prescribe psychotropic medication out of which benzodiazepine prescribing more.
In the present study, depression, anxiety and sleep were the common problems found in patients who were attending their clinic for their medical problems, similar finding was noted in a survey by Mathur (1977) of 638 soldiers hospitalized for physical illnesses and trauma in a military hospital has revealed psychiatric morbidity in 34.5% of them, manifesting mainly in states of depression (47.9%) and anxiety (40.9%). In contrast, a study by Grover and Avasthi (2018) reported that among the three most common psychiatric syndromes seen in CLP setting, delirium figured as one of the three most common diagnoses 79 (87.8%) followed by substance use disorders (70%), self-harm (60%), and depression (38.9%).
The G.P.s were overwhelmingly in favor of using psychotherapy for the treatment of mild mental illness. (16) similarly, more than ½ (54.1%) of the practitioner offer psychological intervention inform of counseling. More than 70% of practitioners are not comfortable prescribing psychotropic medications.
About more than 16% of practitioners were facing difficulty in referring the patient to the psychiatry department. A common problem for referring the patient is stigma patient family members are unwilling to consult a psychiatrist, and sometimes the patient does not agree. The same result was found in a study done by Singh et al 2017 most of the patient was of those who refused to consider the possibility that their presenting symptoms had anything to do with psychiatric illness. About 63.8% refused to consider the possibility that they may have a mental illness. Almost all patients asserted that their symptoms had a “physical” basis.(11)