BMJ 2000;320:614-617 ( 4 March )

General Practice

Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners

Peter Bower, research fellow,  Bonnie Sibbald, professor of health services research. 

National Primary Care Research and Development Centre, Williamson Building, University of Manchester M13 9PL

Correspondence to: P Bower peter.bower{at}man.ac.uk

Objectives: To review the published literature concerning the effects of on-site mental health professionals on general practitioners' management of mental health.
Design: Systematic review of controlled trials.
Setting: Primary care.
Participants: General practitioners and mental health professionals.
Main outcome measures: Consultation rates, prescribing of psychotropics, and referrals to secondary care mental health services by general practitioners.
Results: The effect of on-site mental health professionals on consultation rates was inconsistent. Referral to a mental health professional reduced the likelihood of a patient receiving a prescription for psychotropics or being referred to secondary care, although the effects were not consistent. An on-site mental health professional did not alter prescribing and referral behaviour towards patients in the wider practice population.
Conclusions: The secondary effects of mental health professionals on the clinical behaviour of general practitioners are comparatively modest and inconsistent and seem to be restricted to patients directly under the care of the mental health professional.

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