Hospital doctors' management of psychological problems at a Nigerian tertiary health institution

A questionnaire was sent to all consenting doctors at the University of Ilorin Teaching Hospital, Nigeria. It asked about their management of psychological problems in their clinical practice. Over 90% would welcome more time to talk to patients and agreed that psychological and social factors should be routinely assessed and recorded for patients. Most respondents would refer patients with depression or disturbed behaviours. ‘Ineffective treatment’ and ‘dislike of psychiatric referral’ were not the main reasons for non-referral. A majority of the doctors had initiated treatment for anxiety and insomnia but not for alcohol withdrawal, psychosis, acute confusional state or depression. Doctors' awareness of ‘the impact of psychological factors on the course of physical illness' was high. To sustain this high level of awareness and encourage referral, in-house psychoeducational training of hospital doctors should be intensified. In addition, an increased doctor/patient ratio, public education to reduce stigma and a well developed liaison psychiatric service are imperative.