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Where’s that stethoscope? A survey of psychiatrists’ attitudes to their role in managing physical health

Harriet Greenstone (Medical Education Department, Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK)
Amy Burlingham (Solihull Early Intervention Service, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK)

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 19 February 2020

Issue publication date: 12 May 2020




This study aims to explore current attitudes among doctors working in psychiatry, with regard to their perceived role and their confidence in managing their patients’ physical health problems.


A 20-item electronic questionnaire was distributed to doctors working in psychiatry within two large UK mental health trusts in 2018. Quantitative analysis was conducted, alongside qualitative analysis of free-text comments made by participants.


Many participants perceived their physical examination skills to have deteriorated since working in psychiatry (78 per cent). Participants were questioned on which professional group should hold responsibility for managing the physical health of patients under psychiatric services. A minority felt it should be psychiatrist-led (5 per cent), followed by general practitioner (GP)-led (42 per cent) and then shared responsibility (47 per cent). The majority felt there should be more focused training on physical health in the Core (72 per cent) and Advanced (63 per cent) psychiatry training. Key themes from a framework analysis of qualitative data included potential barriers to shared care, psychiatrists’ concerns regarding their experience and confidence in managing physical health, reasons in favour of shared responsibility, ideas for training and suggestions for improving the current situation.


Psychiatric patients may engage less well with health services, yet psychiatric medication often impacts significantly on physical health. In this context, there is often a blurring of role boundaries between a psychiatrist and a GP, and there is considerable variation between individual teams. There is a consistent call for more physical health training opportunities for psychiatrists and for mental health services to more proactively promote the physical health of their patients.



Declaration of interest: Authors have no competing interests.


Greenstone, H. and Burlingham, A. (2020), "Where’s that stethoscope? A survey of psychiatrists’ attitudes to their role in managing physical health", The Journal of Mental Health Training, Education and Practice, Vol. 15 No. 3, pp. 141-155.



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