Primary care support for youth mental health: A preliminary evidence base for Ireland's Mid-West

Background: Mental and substance use disorders are leading causes of morbidity. Prevention/treatment amongst young people are global health priorities. International data have highlighted primary care and general practice as important in addressing these. Aims: Survey of 128 physicians (GPs) in Ireland's Mid-West (Counties Limerick, Clare, North Tipperary) to document the spectrum of youth mental health problems, describe strategies adopted by GPs in dealing with these, identify barriers (perceived by GPs) to effective care of young mental health patients and collate GP proposals for improved care of this cohort. Methods: Self-administered questionnaire on physician and practice demographics, case management and barriers to care in youth mental health. Results: Thirty-nine GPs (31 %) responded. Mental health and family conflict represented the most frequent reasons why young people attended GPs. Depression, anxiety, family conflict, suicidal thoughts/behaviour, and attention deficit hyperactivity disorder (ADHD) were the most common issues followed by substance abuse and antisocial behaviours. GP referral practices for young people with mental/substance use disorders varied, with distinctions between actual and preferred management due to insufficient access to dedicated youth services and training. GPs stated need for improved access to existing services (i.e., Psychiatry, counseling/psychology, social/educational interventions). A number of GPs surveyed were located, or provided care, in Limerick's 'Regeneration Areas'. Young people in these areas predominantly attended GPs due to mental/substance use issues and antenatal care, rather than acute or general medical problems. Conclusions: GPs play an important role in meeting youth mental health needs in this region and, in particular, in economically deprived urban areas.