APPLICATION OF MODELS OF WORKING AT THE INTERFACE BETWEEN PRIMARY-CARE AND MENTAL-HEALTH-SERVICES IN ISRAEL

Psychiatric morbidity is common in primary care, a large proportion be ing treated without specialist referral. A significant proportion may be undetected or inadequately treated. This article describes current models of mental health services (MHS) working at the interface betwee n primary care and MHS with review of data regarding these models and discussion of the application of these models to the Israeli health sy stem. The shifted out-patient model, primarily provided by psychiatris ts independent of the Primary and Secondary Care Teams, would seem to increase access to psychiatric services, increase treated prevalence o f the disorders and attract a similar population to hospital out-patie nt services. The psychiatric community liaison model aims to improve p rimary care practitioner detection and management skills, might reduce referrals to psychiatrists with similar patient outcome and enables t reatment of patients unwilling to see a mental health professional (MH P). The attached MHP Model would allow access to a greater range of ps ychosocial interventions provided by a primary care team member. The c ommunity mental health team, currently a model not in practise in Isra el, provides a single point of referral for multidisciplinary care but has shown varying patterns of integration and responsiveness to prima ry care. Other interfaces of collaboration such as Balint groups and e ducation are also discussed.