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Chapter 234In addition, the GP is reliant on caregivers understanding symptom presentation, 29, 43, 44, 53, 57, 60-65 overcoming communication difficulties, 43, 57, 69, 72 and providing additional information. 57, 63, 73 It is indicated that the more severe the ID, the more reliant the GP is on caregivers. 63 Therefore, GPs should determine the key persons in a patient’s life 73 and proactively involve them. 49, 72 However, GPs should also realise that some caregivers may give information from their personal perspective, may use different definitions of medical terms than the GP, 44 and may have limited knowledge about the patient 53, 62, 72, 81, 94 or limited communication skills themselves. 42, 44CollaborationThe publications emphasise the importance of GPs collaborating with other professionals in the care for patients with ID and MHD. The collaborative partners mentioned are diverse and comprise both medical specialists, for example psychiatrists and pharmacists, and services like community or addiction services. Described areas for collaboration are the assessment of symptoms, 43, 44, 49, 50, 56, 63, 64, 72, 75 level of communicational skills and cognitive functioning, 44, 86 and obtaining advice on referral, 31, 72, 78 treatment,30, 44, 48-50, 72, 75, 86 or prevention. 49 GPs’ options include referral for collegial advice, 31, 48, 72, 94 handing the patient over to other professionals, 44 or joining a multidisciplinary team giving integrative care to the patient. 93, 98, 101 The latter is described as particularly desirable when the patient has a more severe ID or is in a highly complex situation. 39, 44, 99Effective collaboration is seen as beneficial for the outcome of mental healthcare in primary care 28, 39, 42, 44, 93, 94, 96, 98, 102 as it is believed to increase the identification of MHDs, improve access to mental healthcare, 98, 101and reduce hospitalisation 103 and costs. 98, 101 However, inappropriate referrals are reported, 90, 94 resulting from unclear referral options and procedures. 44, 45, 96, 100, 104 Adequate information exchange between GPs and other professionals, in the form of standardised, timely-sent letters, is underlined as important for sharing essential information 38, 62, 94, 105-107 and continuity of care. 105, 106 Yet, audit studies on referral letters and letters from psychiatrists to GPs show that important information is often missing. 62, 94, 100, 105, 107 Finally, it is stated that, in multidisciplinary collaboration, the alignment of responsibilities in treatment and follow-up should be clear.Katrien Pouls sHL.indd 34 24-06-2024 16:26