## Survey says ...
2000 Annual Clinical Focus hit the mark

Even as U.S. Surgeon General David Satcher, M.D., Ph.D., is calling on primary care physicians to take a more active role in detecting and treating mental illness, AAFP members are saying they're up to the task.

Two surveys -- one mailed to AAFP members before and one after last year's Annual Clinical Focus, Mental Health 2000 -- gauge the program's impact on members with regard to managing mental illness in their patients.

For each of nine disorders, physicians were asked to rate their pre- and post-ACF levels of knowledge and performance in recognizing characteristic signs and symptoms. Statistically significant gains were seen in reported knowledge levels about depression, anxiety, panic disorder and dementia (see graph at right). Respondents also reported statistically significant increases in levels of performance (detecting and treating) for depression, anxiety and dementia.

ACF Medical Director Stephen Spann, M.D., of Houston says the results appear to indicate that respondents did, in fact, increase their knowledge about a number of mental health problems commonly seen in family practice, although he cautioned against overinterpreting the data.

Other areas in which statistcally significant strides were made were:

- knowledge about predisposing factors for mental illness,
- knowledge of primary prevention interventions,
- knowledge and use of available psychotropic agents, and
- overall comfort level in diagnosing mental health problems.

Physicians also commented on what changes they would make in their practices as a result of having participated in Mental Health 2000. Among the changes respondents cited most frequently were:

- increased use of screening and diagnostic tools,
- expanded use of antidepressants,
- greater emphasis on encouraging patients to explore community resources,
- better implementation of patient education initiatives and
- enhanced incorporation of mental health teaching principles into family practice residency training.

Finally, respondents suggested additional educational programs they would find helpful in their practices, including coursework on cognitive behavioral counseling, emotional problems in children, marital counseling and the special emotional needs of men.

The first questionnaire went out to 2,000 members in February 2000; 228 responses were received for a return rate of 11.4 percent. Those respondents were again surveyed this past March and the results compared with the earlier self-reported knowledge and skill levels.

For more information about the surgeon general's mental health initiative, go to http://www.aafp.org/fpr/20010600/01.html . For more information about Mental Health 2000, including a listing of supporting and cooperating partners, go to http://www.aafp.org/acf/2000/ .

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