Counselling in primary care - a general practitioner’s perspective

Introduction: Counselling in Primary care (CIPC) is a new service introduced by the HSE in 2013, providing short-term counselling for medical-card holders, suffering from mild to moderate mental health problems. Aims: To explore GP’s views on CIPC for the treatment of mild to moderate mental health disorders. Methods: Qualitative semi-structured interviews were conducted with GPs who had previously utilized the CIPC service in the Cork/ Kerry region. Forty GPs were identified and sent invitation letters. GPs were purposefully sampled based on criteria of location (urban/rural), gender, practice size (single handed/group) and length of time qualified. A total sample size was generated using the ‘ten plus three’ method. Interviews were carried out in person, transcribed verbatim and analyzed using the framework analysis method. Results: Nineteen GPs were interviewed. Core themes emerged and were analyzed. 1. GPs unanimously agreed that CIPC has been of benefit in treating mild to moderate mental health disorders. 2. Suggested improvements to the service were made, including allowing GP visit card holders to avail of the service (n=10) and adolescents aged between 16 and 18 (n=5). 3. A majority (n=12) of GPs interviewed expressed the opinion that a combination of talk therapy and medication was associated with the best outcomes in treating mild to moderate mental health disorders. Conclusion: CIPC seems to improve mental health services at a primary care level. While improvements can certainly be made to the service, GPs report positive patient outcomes and a reduction in psychiatric referrals for patients who can be suitably managed within the community