Primary care psychology in Veneto Region: preliminary results

Mental illness accounts for 14% of the total global burden of disease. The prevalence of psychological suffering is greater than the actual request for clinical consultation in Europe. Health care system has not yet adequately responded to the burden of mental disorders. To cope with mental disease, WHO proposed the European Mental Health Action Plan (EMHAP) 2013-2020, which recommends to improve access to safe, competent, effective and community-based mental health services. Primary Care Psychologist (PCP) can reduce the gap between the need of psychological treatment and its provision. To improve the access to psychological care, a new mental health service was created in two public health care districts of Veneto Region: ULSS 7 and ULSS 4. The service provided direct referral to a co-located PCP working together with the general practitioner (GP). This study presents the preliminary results of the first experimentation. Primary outcome was well being, measured pre-post PCP interventions with patient's self reported PGWBI. Secondary outcome was the treatment considered by the GP as the best alternative to the referral to the PCP and the satisfaction. Qualitative data were gathered through interviews and focus groups with GPs and PCPs. All data were compared with EMHAP guidelines. 170 people accessed the service. Primary outcome showed an improvement in PGWBI score after the PCP intervention. Secondary outcome showed that GP avoided drugs prescriptions (49%), referral to other services (32%) and laboratory tests (12%) through the referral to the PCP. Patients, psychologists and GP reported great interest and high satisfaction with the service. PCP interventions were effective in improving well-being and reducing drugs prescriptions and laboratory tests. The results stress the importance of the PCP implementation, to intercept unexpressed psychological needs.