THE COLLECTION OF GENERAL-PRACTICE DATA FOR PSYCHIATRIC-SERVICE CONTRACTS

A three-month prospective collection of primary care data from general surgery attendances in an inner London Health District was carried ou t to inform the setting of contracts for psychiatric services. This in volved 21 general practitioners (GPs) selected from a total of 102 in the District. Information was collected on mental health disorders det ected by GPs among the attenders, the resultant volume of care provide d by the GPs, the referrals made to secondary care and other agencies, and the types of care identified by the practitioners as appropriate for a patient but which are currently not accessible or available. We found that 45.9 per cent of all patients (17319/37733) registered with the 21 GPs were seen in three months. There was an over-representatio n of White and Black Caribbean patients and an under-representation of Bangladeshi, Chinese, Black African and Black Other patients in the s tudy population. Mental health disorders were detected in 13.3 per cen t (2304) of all attenders. The commonest problems were depression (17. 7 per cent), acute stress reaction (15.5 per cent), anxiety (15.1 per cent), drug abuse (7.2 per cent), schizophrenia (5.8 per cent) and alc ohol abuse (5.3 per cent). It was found that 37.3 per cent (860) of al l attenders received medication, 66.5 per cent (1532) were counselled by the GPs and only 4.4 per cent (102) were referred to a psychiatrist ; 16.3 percent (375) of those with mental health disorders were identi fied by the GPs as having a service need which the District's psychiat ric service could not meet. The GPs felt that this service need would be best met by a counselling service, community psychologists and comm unity psychiatric nurses. It is concluded that although definitions of mental health problems are difficult, information from primary care c an be collected with the help of G Ps. The findings were useful for th e setting of a new service contract for psychiatric services in Tower Hamlets.