Can shared care change self-reported skills in managing psychiatric disorder?

At the end of this session, participants will be able to: 1) Understand ways of assessing changes in practice following the introduction of shared mentalhealth care. 2) Apply these to their own setting. 3) Understand the strengths and limitations of these methodologies.Introduction:   To evaluate a shared care partnership between mental health services (MHS) and two family medicine clinics in Halifax, including a directory of hospital based mental health service, a memorandum of understanding (MoU) to streamline referrals and a consultation-liaison (C-L) service.Method: We wanted to compare differences over time between a clinic that had a shared care service (Cowie Hill) with one that did not (Camp Hill) using aquasi-experimental design and self-report questionnaires adapted from a similar study in Australia (Kisely et al, 2002). GPs and primary care nurses were asked about their level of knowledge, skills and degree of comfort in managing and/or referring the following psychiatric disorders derived from the primary care version of the 10th version of the International Classification of Diseases (ICD10): psychosis,  depression, anxiety, personality disorders, somatoform disorders and stress related disorders.Results: We have completed just under 15 baseline interviews and plan to re- administer the questionnaire in 6 and 12 months’ time. This will be extended to compare 5 other existing shared care sites in Capital District with those family clinics that are subsequently offered a shared care service in the following year.Discussion and Conclusions:   This study relies on self-report and retrospective information on practitioner work practices, knowledge and interests. However, the methodology was applicable to Canadian shared care and can be used to evaluate GPs' and primary care nurses’ self-reported skills in managing psychiatric disorder, as well as referral behaviour.