The choice and the change of the allocated primary mental health professional in community-based mental health services: a focus-group qualitative study

Giulia Rioli 1-3, Silvia Ferrari 1,4, Riccardo Vandelli 5, Nina Giambalvo 1, Alessandro Minarini 1, Cecilia Artoni 1, Giacomo Galli 1, Gian Maria Galeazzi 1,4

1 Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; 2 Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; 3 Department of Mental Health and Drug Abuse, AUSL Reggio Emilia, Reggio Emilia, Italy; 4 Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; 5 School of Medicine and Surgery, University of Modena and Reggio Emilia, Modena, Italy

Objectives

It is generally agreed that it is important to take into consideration users’ preferences in the choice of their allocated primary mental health professional (PMHP). Our aim was to explore experiences of users, care givers and psychiatrists on users’ initial choice and request of change the PMHP in Community Mental Health Services (CMHSs).

Methods

Three focus groups were conducted in March-May 2017 in two CMHSs in Modena, Northern Italy. Transcripts were analyzed using MaxQda 11. 

Results

Six users, 7 psychiatrists and 5 care givers were enrolled. Casual or fixed allocation is commonly performed (so-called “fixed rota”). Lack of empathy and a bad therapeutic relationship seem to be the most important reasons to change the PMHP. 

Conclusions

Neither users nor professionals are generally involved in the initial choice of the PMHP. The availability of evidence-based guidelines for managing users’ request to choose/change the PHMP may improve quality of care.

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