Roles of psychiatrists and other professionals in mental healthcare: results of a formal group judgement method among mental health professionals

Br J Psychiatry. 2005 Aug:187:173-9. doi: 10.1192/bjp.187.2.173.

Abstract

Background: Professional boundaries between psychiatrists and other mental health professionals are difficult to set. Empirical evidence for the distribution of diagnostic and treatment tasks among professionals is lacking.

Aims: This study examines the 'collective sense of the profession' about the relationship between patient characteristics and the contribution of tasks by disciplines.

Method: An adapted RAND appropriateness method was used. Eighty-six professionals judged 77 case descriptions of psychiatric patients on the contribution to diagnostic and treatment tasks of eight selected disciplines.

Results: In two multi-level models the variance explained by the judges' characteristics was 3.7% for diagnostic tasks and 4.5% for treatment tasks. The variance explained by the patient characteristics was zero for diagnostic and 0.5% for treatment tasks. The variance explained by the indicated disciplines was 36.8% for diagnostic and 12.6% for treatment tasks.

Conclusions: The collective sense of the profession on the contribution of psychiatrists to mental healthcare is unambiguous but not related to patient characteristics. It seems to be based on an a priori ranking order of disciplines.

MeSH terms

  • Analysis of Variance
  • Female
  • Health Personnel*
  • Humans
  • Interprofessional Relations
  • Judgment
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy*
  • Physician's Role*
  • Pilot Projects
  • Professional Competence
  • Psychiatric Nursing
  • Psychiatry
  • Psychotherapy
  • Social Work