Effects of mental health training and clinical audit on general practitioners' management of common mental disorders

Publisher Website
Google Scholar
Abstract
Objective: To evaluate the effects of a seminar‐based training program and clinical practice audit on general practitioners' (GPs') knowledge and management of common mental disorders. Design: Survey of GPs' knowledge before and after training, and clinical practice audit and re‐audit after feedback. Participants and setting: GP volunteers from around Australia in 1998–1999: 1008 completed the pre‐training test, 190 the post‐training test, 386 the first audit (33 235 patients), and 157 of these the re‐audit (13 280 patients), with 57 undertaking both audit and training. Interventions: Four‐seminar, 12‐hour training program focused on improving GPs' capacity to identify and manage patients with depression and anxiety; practice audit with patient‐ and practice‐based feedback on diagnosis and treatment of common mental disorders. Main outcome measures: Scores on pre‐ and post‐training knowledge tests; self‐rated improvements in confidence in managing patients with mental disorders after training; rates of psychological diagnoses and treatment by GPs on first audit and re‐audit. Results: GPs' knowledge of pharmacological treatments and clinical management improved after the training program (PP< 0.001), and their diagnosis rates increased over time (36% to 39%; PPPP< 0.001], and 25% versus 19% at re‐audit [P< 0.001]). Conclusion: Clinical audits may heighten awareness of mental disorders, but, on their own, they do not improve mental health practice. A relatively brief but skills‐based training program may contribute to better management of patients with common mental disorders by increasing GPs' confidence and competence.