Public and private psychiatry : can they work together and is it worth the effort?

Yung, Alison, Gill, Lisa, Sommerville, Elizabeth, Dowling, Bernie, Simon, Kim, Pirkis, Jane, Livingston, Jenni, Schweitzer, Isaac, Tanaghow, Amgad, Herrman, Helen, Trauer, Tom, Grigg, Margaret and Burgess, Philip 2005, Public and private psychiatry : can they work together and is it worth the effort?, Australian and New Zealand journal of psychiatry, vol. 39, no. 1-2, pp. 67-73, doi: 10.1111/j.1440-1614.2005.01511.x.

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Title Public and private psychiatry : can they work together and is it worth the effort?
Author(s) Yung, Alison
Gill, Lisa
Sommerville, Elizabeth
Dowling, Bernie
Simon, Kim
Pirkis, Jane
Livingston, Jenni
Schweitzer, Isaac
Tanaghow, Amgad
Herrman, Helen
Trauer, Tom
Grigg, Margaret
Burgess, Philip
Journal name Australian and New Zealand journal of psychiatry
Volume number 39
Issue number 1-2
Start page 67
End page 73
Total pages 7
Publisher Informa Healthcare
Place of publication London, England
Publication date 2005
ISSN 0004-8674
Summary OBJECTIVE: Partnerships in mental health care, particularly between public and private psychiatric services, are being increasingly recognized as important for optimizing patient management and the efficient organization of services. However, public sector mental health services and private psychiatrists do not always work well together and there seem to be a number of barriers to effective collaboration. This study set out to investigate the extent of collaborative 'shared care' arrangements between a public mental health service and private psychiatrists practising nearby. It also examined possible barriers to collaboration and some possible solutions to the identified problems.

METHOD: A questionnaire examining the above factors was sent to all public sector mental health clinicians and all private psychiatrists in the area.

RESULTS: One hundred and five of the 154 (68.2%) public sector clinicians and 103 of the 194 (53.1%) private psychiatrists returned surveys. The main barriers to successful collaboration identified by members of both sectors were: 'Difficulty communicating' endorsed by 71.4% of public clinicians and 72% of private psychiatrists, 'Confusion of roles and responsibilities' endorsed by 62.9% and 66%, respectively, and 'Different treatment approach' by 47.6% and 45.6%, respectively. Over 60% of private psychiatrists identified problems with access to the public system as a barrier to successful shared care arrangements. It also emerged, as hypothesized, that the public and private systems tend to manage different patient populations and that public clinicians in particular are not fully aware of the private psychiatrists' range of expertise. This would result in fewer referrals for shared care across the sectors.

CONCLUSIONS: A number of barriers to public sector clinicians and private psychiatrists collaborating in shared care arrangements were identified. The two groups surveyed identified similar barriers. Some of these can potentially be addressed by changes to service systems. Others require cultural shifts in both sectors. Improved communications including more opportunities for formal and informal meetings between people working in the two sectors would be likely to improve the understanding of the complementary sector's perspective and practice. Further changes would be expected to require careful work between the sectors on training, employment and practice protocols and initiatives, to allow better use of the existing services and resources.
Language eng
DOI 10.1111/j.1440-1614.2005.01511.x
Field of Research 111714 Mental Health
HERDC Research category C1.1 Refereed article in a scholarly journal
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