Treatment of patients designated by family doctors as having emotional problems.

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Abstract
Immediately prior to starting full operations in a new Mental Health Center in the largest of the 31 medical groups of the Health Insurance Plan of Greater New York, interviews were conducted among family physicians and patients of the group concerning medical care that may have been provided for emotional problems by family physicians and others. The data obtained will provide baseline information in a study of the impact of psychiatric treatment on medical care for emotional disorders. Two samples of patients age 15 and older, seen during a 3-month study period were studied: a Psychiatric Diagnosis Sample of patients reported by family physicians as having a "mental, psychoneurotic or personality disorder" (N = 435); and a Comparison Sample of patients with no reported emotional condition during the study period (N = 521). Twenty-six percent of the Psychiatric Diagnosis patients were referred by family physicians to the medical group psychiatrist for consultation (when treatment was not yet available). According to family physician reports the likelihood of a psychiatric referral was increased for patients whose emotional conditions were chronic and for those for whom the condition interfered with regular life activities. Among patients for whom the family physician prescribed drugs for their emotional condition and for whom the drugs were not found helpful to the patient, there was also a greater likelihood of referral as was also the case for patients who were reported by the physicians as not responding well to doctor-patient discussions about their emotional problems. In general, the results of patient interviewing conformed with study findings among family physicians.