Family medicine patients and mental health referrals: implications for primary care physicians

Abstract

This was an exploratory investigation of the likelihood of compliance by family medicine patients if their Primary Care Physician (PCP) referred them to mental health treatment. Participants were 116 adults who were at the Family Medicine Center (FMC) in Fort Collins, Colorado, for medical appointments. Participants completed a questionnaire which measured demographic information, socioeconomic and health insurance status, relationship with physician and FMC, past mental health treatment, interest in treatment modalities, perceived mental health problems, importance of decision-making factors, likelihood of complying with a mental health referral by their PCP, and reasons they would not comply with such a referral. Objectives were to describe the sample and to explore which variables were related to participants agreeing to comply with therapy referrals. Participants were classified as either "compilers" or "noncompliers" based upon their responses to the four items measuring likelihood of complying with their physician's referral. Five independent variables were significantly related to the compliance dependent variable. Those more likely to comply were those who had attended more than one therapy session in the past, those whose PCP had more strongly urged them to attend therapy in the past, those who believed that they had more serious mental health problems, those who placed more importance in decision-making factors, and those who had been FMC patients longer. A forward stepwise multiple regression analysis with compliance as the dependent variable indicated that perceived mental health problems (49.7% of variance, standardized β=0.71) and number of times the participant had attended therapy in the past (23.9% of variance, standardized β=0.52) predicted compliance, R2=0.736, p<.01. Most participants reported that they would comply with their PCP's referral to therapy. Demographic characteristics were not related to likelihood of complying, nor were income level or having private insurance. Conclusions included the important role of the PCP in linking medical patients with mental health treatment. Recommendations for PCPs are provided.