BMJ 2000;321:701 ( 16 September )

Letters

Effect of on-site mental health professionals

    Longer trials are needed
    Authors' reply

Longer trials are needed

The first 150 words of the full text of this article appear below.

EDITOR---The systematic review by Bower and Sibbald of on-site mental health professionals was a welcome addition to the literature on the effectiveness of the talking therapies in primary care.1 In view of the effect on consultation rates, prescribing of psychotropic drugs, and referrals to secondary care, the conclusion drawn was that the evidence for a direct effect was strongest in relation to general practitioner referrals to secondary care providers.

Six randomised controlled trials of direct effects on referrals were identified. Three were reported as showing referrals to be significantly reduced. Although some of the limitations of the studies were discussed, each of the six trials is flawed in terms of being able to generalise to everyday primary care

One trial was described as showing a significant reduction in referrals when the stated P value was 0.56, which is not significant.2 Furthermore, the therapy offered was from a psychiatrist based . . . [Full text of this article]
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Relevant Article

Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners
Peter Bower and Bonnie Sibbald
BMJ 2000 320: 614-617. [Abstract] [Full Text] [PDF]

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