Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners.

OBJECTIVES To review the published literature concerning the effects of on-site mental health professionals on general practitioners' management of mental health. DESIGN Systematic review of controlled trials. SETTING Primary care. PARTICIPANTS General practitioners and mental health professionals. MAIN OUTCOME MEASURES Consultation rates, prescribing of psychotropics, and referrals to secondary care mental health services by general practitioners. RESULTS The effect of on-site mental health professionals on consultation rates was inconsistent. Referral to a mental health professional reduced the likelihood of a patient receiving a prescription for psychotropics or being referred to secondary care, although the effects were not consistent. An on-site mental health professional did not alter prescribing and referral behaviour towards patients in the wider practice population. CONCLUSIONS The secondary effects of mental health professionals on the clinical behaviour of general practitioners are comparatively modest and inconsistent and seem to be restricted to patients directly under the care of the mental health professional.