Presenting prevalence and management of psychosocial problems in primary care in Flanders.

BACKGROUND: Psychosocial problems are widespread but reliable data about management are sparse. An overall view is missing and there is a need for a wider framework to include the data available in health care and welfare practice, databases and research output. The question under scope is: how are psychosocial problems presented and handled in primary care in Flanders?

METHODS: A mixed method was used. Using a 'fishbone diagram' (1) we obtained a basic structure to visualize the main (problem) areas and challenges. A literature study (2) and semi-structured interviews with health care and welfare professionals in primary care (3) were performed. Finally, two interdisciplinary focus groups were organized (4).

RESULTS: In Flanders, there is no tradition of multidisciplinary psychosocial research in primary care causing a lack of integrated data. Data only exist within disciplines without transdisciplinarity. The data are difficult to interpret due to different labeling and registration processes between disciplines and settings. However, we can find some general trends: assistance to patients with psychosocial problems is based on what can be offered, rather than on patient needs; drug treatment remains popular; referral of patients within primary care or to secondary care does not seem to be obvious. Among all disciplines, there is a great need for more collaboration and considerable advantages are to be expected from the growing emergence of multidisciplinary practices; multiculturalism appears to take an increasingly important place within primary care in Flanders and has implications for the care offered; and treatment effectiveness in psychosocial problems seems to be more related to the person of the caregiver than to a specific discipline, theory or type of treatment.

CONCLUSIONS: Based on our results, we strongly advise stimulation and organization of integrated (multidisciplinary) research regarding psychosocial problems in primary care and a more consistent registration by the agencies in primary care.