CHANGES IN FAMILY DOCTORS SERVICES FOR EMOTIONAL DISORDERS AFTER ADDITION OF PSYCHIATRIC TREATMENT TO A PREPAID GROUP PRACTICE PROGRAM

The family doctor's medical care for emotional problems in a prepaid group practice plan during a period when mental health services were limited to psychiatric consultation is compared with the situation two years later when services included psychiatric treatment at no cost to the patient. During this time the annual rates for psychiatric consultation increased from 7 to 11 per 1000. There was a greater tendency during the later period to prescribe a wider range of drugs, and stronger drugs. Psychiatric referrals for patients with a wide range of emotional problems, including those whose emotional problems interfered with three or more life activities and those whose emotional problems caused no interference, increased. There was an increased tendency in the later period to refer patients whose self-reports described less serious or less acute problems. © Lippincott-Raven Publishers.