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Roles of psychiatrists and other professionals in mental healthcare

Results of a formal group judgement method among mental health professionals

Department of Clinical Psychology, Radboud University, Nijmegen, and Gelderse Roos Institute for Professionalisation, Wolfheze

BEA TIEMENS, PhD

Gelderse Roos Institute for Professionalisation, Wolfheze

AD KAASENBROOD, MD

Gelderse Roos, Arnhem, The Netherlands

Correspondence: Professor Giel Hutschemaekers, Gelderse Roos Institute for Professionalisation, Postbus 27, 6870 AA Renkum, The Netherlands. E-mail: g.hutschemaekers{at}degelderseroos.nl

Declaration of interest None.

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.

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