FAMILY PHYSICIANS AND THE MENTAL-HEALTH SYSTEM - REPORT FROM THE MENTAL-HEALTH SUPPLEMENT TO THE ONTARIO HEALTH SURVEY

OBJECTIVE To determine family physicians' role in the mental health ca re system. DESIGN The Mental Health Supplement to the Ontario Health S urvey is an epidemiologic, retrospective, home-interview survey. Resul ts reported here are based on responses of a weighted sample of patien ts aged 15 to 64. SETTING Ontario, 1990 to 1991. PARTICIPANTS Random s ample of 9953 household residents. MAIN OUTCOME MEASURES Standardized assessment of mental disorders, associated risk factors and disability , and patterns of use of mental health services. RESULTS More people s eek mental health services from their family physicians (FPs) than fro m psychiatrists, social workers, or psychologists. Among patients who consulted for mental health purposes, more than 35.4% saw FPs only, 24 .7% saw FPs and other mental health care providers (psychiatrists, psy chologists, social workers, others), and 40% saw other mental health c are providers only. There were few sociodemographic, diagnostic, or cl inical severity differences between the FP-only group and the other tw o groups. Some evidence suggested FPs saw more recent onset cases, but they were also involved in joint care for more complex or disabled ca ses. More than 57% of those seeing FPs received medication; 43% receiv ed other forms of care. Those seeing FPs only made four visits per yea r; those who consulted other mental health professionals made 14 to 20 . CONCLUSIONS Our study confirms FPs' important role in the current me ntal health care system.