Abstract

ACUNA, Julia; ROIZBLATT, Arturo; FULLERTON, Claudio  and  BOTTO, Alberto. Teaching experience in Psychiatric Consultant-laison in Primary Care Settings. Educ. méd. [online]. 2007, vol.10, n.1, pp.37-43. ISSN 1575-1813.

Authors describe an initial program for training residents as consultants in Primary Care Settings. This program was developed and applied by the Department of Psychiatry and Mental Health of the Faculty of Medicine of the Universidad de Chile between 2003 and 2004. Method: Preliminary program was established, with objectives and evaluation schemes for the correct achievement of the objectives by the residents in two areas: learning and clinical work. Residents were assigned to different primary health centers, under a supervisor. Results: Good evaluations (superior rank) for residents' achievements in learning objectives were observed. Lower ratings were for clinical objectives. Supervisors evaluated the whole process positively; the main difficulty mentioned was the double work schedule required in the whole process of Psychiatry Consultant-laison in Primary settings. The discussion emphasizes the importance of supervision, which should be active in watching areas that hinder the process; making it necessary to detect problems in need of change to be established as soon as possible. Greater difficulties were originated on explicit and/or underlying medical or general health care team resistances. "Urgent demands" and emotionally overwhelming patients delayed competent reception and treatment. Supervisor and resident should offer proper and timely advice, to allow the overcoming of the difficulties, then general health professionals would be able to manage the emotional demands, explicit or tacit, presented in the interview. Some elements should be treated in the process, itself complex, of teaching consultant-liaison during the psychiatry resident program. Conclusion: Nevertheless, psychiatry consultant-liaison in primary care settings was highly appreciated as necessary by all the actors involved in providing care for patients presenting mental health problems in primary health care settings.

Keywords : psychiatry consultant-liaison; residents; primary care; mental health.

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