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Background: Team based care is an essential ingredient of chronic disease management including chronic mental illness. Effective health care teams include members who have defined, yet intersecting roles, where mutual respect characterises professional interaction and the patient’s well-being is central. The aim was to explore the perception of psychologists, psychiatry registrars and psychiatrists with respect to GPs’ role in managing difficult-to-treat-depression (DTTD). Methods: A previously developed semi-structured interview schedule comprising six questions was used. Thirty-two health professionals participated. Data were analysed using the Framework method. Findings: Four main themes emerged: 1) The team approach was important, particularly to ensure information accuracy and/or when responding to patient needs and pressures; 2) Referrals, usually generated by GPs can be a vehicle for other health professionals to provide advice to the GP; 3) Availability and accessibility often depended on health professionals work location and knowing how to navigate the system; 4) Limited availability of government funding impacts on patients’ accessibility to health professionals. Discussion: Interprofessional relationships were described as paramount. Appropriate and timely referrals are integral to patient management, regardless of challenges. Ongoing challenges include program funding, workforce numbers and costs to patients. Improvement to mental health care access was noted, even for patients among relatively disadvantaged groups and those receiving Medicare Benefits Schedule-subsidised services. Conclusion: Despite adequate GP/specialist communication, the delivery of optimal team based care to patients with difficult-to-treat depression is compromised by lack of access to specialised services and inadequate funding.

open journal of psychiatry

Interprofessional Communication and Relationships in the Management of “Difficult to Treat” Depression: Perceptions of the Role of General Practitioners