ABSTRACT
OBJECTIVE@#The study objective was to determine current perspectives and practices of residents- and fellows-in-training in non-psychiatric specialties when dealing with patients with behavioral and psychological problems at the University of Santo Tomas Hospital. It aimed to identify the trainees’ perceived role, and approach to diagnosis and treatment of psychiatry. Lastly, the study goals included gathering insights and suggestions on the improving psychiatric services in the hospital. @*METHODOLOGY@#This was a cross-sectional descriptive study surveying non-psychiatric residents- and fellows-in-training with clinical or patient encounters at the University of Santo Tomas Hospital in 2015. This was followed by the delivery of a lecture on psychological response to illness, an open forum, and an option for focus group discussion thereafter. Data and results underwent further statistical analysis and grouping into themes.@*RESULTS@#Among the 256 qualified subjects, a total of 178 respondents participated in the survey (69.53%). Perceptual disturbance was perceived as a behavioral problem that was most difficult to handle, followed by suicidality/self-harming behavior as well as addiction. Sleep disturbance (n=63) was cited as the behavioral manifestation that was directly managed by trainees while suicidal behavior / self-harm (n = 173), and thought disturbances (n = 164-166) were mainly cited as presentations that were referred to psychiatry. Services like Clinical Psychology and Neurology were among the specialties to whom behavioral problems were referred to. In terms of perception of psychiatric diagnosis, a pure psychological approach was deemed by 40.31% of the respondents, while only 18.85% viewed psychiatric diagnosis taking a bio-psycho-socio-spiritual approach. Psychiatric treatment approach however was deemed as a combination of biomedical, psychological, and social by 63.93%. The trainees’ view of psychiatry’s role in their practice encompassed management of psychiatric presentations of medical conditions, its complications, or treatments, psychological reactions to medical conditions or treatments, medical presentations of psychiatric conditions or treatments, and co-morbid medical and psychiatric conditions, pre & post-procedural consultation & screening, and other consultations including promotion of general mental wellness. Suggestions for improvement covered (1) the referral system/process, including a general agreement on the need for a standardized referral form (2) an intensification of education & information dissemination among colleagues, (3) psychoeducation for patients and the lay, (4) expansion and improvement access through infrastructure, (5) open collaboration, as well as (6) added services including patient support groups.@*CONCLUSION@#This study allowed for a better understanding of non-psychiatry trainees’ perspectives and approach towards patients manifesting with behavioral problems approach from non-psychiatric specialties and their understanding of psychiatry. Trainees had a good understanding of the role of psychiatry in their practice, while identifying barriers towards optimizing referral. This study was an example on how opening communication lines with the different subspecialties can bring to light, ways on how the hospital’s psychiatric services could be improved towards better patient service and care.