Pathways to mental health care and utilization of primary care services, and patients thoughts about family physicians' professional skills

Mental disorders are the leading causes of disability, worldwide. The Mental Health Policy Act, issued in 2006 by the Ministry of Health, advised that mental services need to be community-based, and integrated with primary care services. The main aim of our study was to examine the pathways to mental health care and the role of family physicians in this process. We also wanted to learn opinions and attitudes of patients about the competence levels of family physicians in treating mental and physical disorders. This study was conducted between January 2018 and August 2018 with 265 participants. The family physicians were the least likely to be the first point of contact for psychological problems (%6.8); most of the patients (%54.5) contacted a mental health specialist directly. Psychiatric diagnosis had an effect on the choice of type of doctor for the first contact: anxiety patients attend family physicians as first contact more often compared to patients with other diagnoses. Once the psychiatric diagnosis is established, contact with family physicians is common: most patients go to their family physician for physical symptoms. Schizophrenic patients go for refills, whereas anxiety patients go to their family physician for counselling more often than others. Patients who see family physicians as competent for treating mental patients tend to choose family physicians as the first point of contact more often than others. There were no differences in delay to treatment among patients who contacted different carers as first contact. The majority of patients think that family physicians are capable about treating physical disorders; most of them don't have any idea, however, about family physicians' ability to manage mental disorders. Key words: primary care, mental health services, pathways to care, delay