Icelandic primary care physicians' perceived competence in detection and treatment of behavior disorders

by Sigurðsson, Haukur.

William H. O’Brien, Advisor While mental disorders are prevalent in primary health care settings, they often go undetected and untreated. There are no records to be found on studies of the effectiveness of Icelandic primary care physicians in diagnosing and treating mental illness. However, it is likely that the Icelandic primary health care system is not significantly different from systems in other countries that show poor detection and treatment of mental illness. The present study is the first study aimed at evaluating Icelandic primary care physicians’ experience with mental health problems and perceived competence in detection and treatment of behavior disorders. Furthermore, it is the first empirical attempt to assess the need for improved primary mental health care in Iceland. This exploratory study was designed to assess primary care physician’s perception of: 1) Prevalence and significance of different behavior disorders in the primary health care clinics, 2) their ability to detect and treat behavior disorders within the primary health care system, 3) the physician’s access to mental health services as well as quality of communication with mental health professionals, and 4) barriers to adequate mental health care within the Icelandic primary health care system. Main results suggest that Icelandic primary care physicians correctly identify that they, among all health care workers, are the ones seeing the highest proportion of people in the community suffering from mental health problems. They also correctly identify that depression and anxiety are the most prevalent groups of behavior disorders in primary care. However, while they seem to be quite confident in their ability to treat and detect mental illness, extensive amount of research from around the world show extremely poor iv detection and treatment of behavior disorders in primary care. Most Icelandic primary care physicians view the detection and treatment of mental illness in their clinic as adequate or good. However, most agree that limited time with patients and limited access to mental health professionals are factors that interfere with adequate mental health services in their clinic. Implications for mental health care in the Icelandic primary care system are discussed. v