General Practitioners and Mental Health

Background: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. Aims: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. Method: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions ( Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. Results: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician’s interest in mental health topics. Conclusions: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.

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Challenging care work: General practitioners’ perspectives on caring for young adults with complex psychosocial problems

Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine ◽

10.1177/1363459319874100 ◽

2019 ◽

pp. 136345931987410

Author(s):

Julie Høgsgaard Andersen ◽

Tine Tjørnhøj-Thomsen ◽

Susanne Reventlow ◽

Annette Sofie Davidsen

Keyword(s):

Mental Health ◽

Primary Care ◽

Young Adults ◽

General Practitioners ◽

Mental Health Problems ◽

Psychosocial Problems ◽

Health Problems ◽

Care Work ◽

Psychiatric Nurses ◽

Provision Of Care

The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, young adults who have complex psychosocial problems, and who are not in education or work, cause political and academic concern. They are also in regular contact with their general practitioners, the Danish municipalities and psychiatric services. However, little is known about general practitioners’ perspectives on caring for this vulnerable group of patients. In this article, we investigate how general practitioners’ care work is shaped by the bureaucratic management of care in a complex infrastructure network comprising the general practitioners, psychiatry, the municipalities and the young adults. The analysis is based on interviews and focus groups with general practitioners, psychiatric nurses and social workers. We employ Tronto’s concept of care and the concept of boundary work as a theoretical framework. We argue that general practitioners strive to provide care, but they are challenged by the following: contested diagnostic interpretations and the bureaucratic significance of diagnoses for the provision of care from psychiatry and the municipalities, systemic issues with handling intertwined social and mental health problems, and the young adults’ difficulties with accessing and receiving available care.

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Mental Health Research in General Practice

Australasian Psychiatry ◽

10.1080/j.1440-1665.2005.02185.x ◽

2005 ◽

Vol 13 (2) ◽

pp. 181-184 ◽

Cited By ~ 6

Author(s):

Harry Minas ◽

Steven Klimidis ◽

Renata Kokanovic

Keyword(s):

Mental Health ◽

General Practice ◽

General Practitioners ◽

Health Research ◽

Mental Health Research ◽

Practice Research ◽

Practice Setting ◽

Key Issues ◽

Practice Time ◽

Time Limitations

Objective: To explore problems in carrying out a mental health research project in the general practice setting. Method: Open-ended interviews were conducted with general practice stakeholders, focusing on impediments to the conduct of mental health research in general practice and possible means for improving the participation of general practitioners in such research. Participants in the consultations were members of ?ve divisions of general practice, senior staff within an academic department of general practice, four general practitioners and a research group engaged with general practice research. The discussions were recorded in detailed interview notes, and key issues and themes emerging from consultations were derived by the researchers. Results: Three main themes summarized most of the issues reported through the consultations, including structural issues (e.g. disruption of practice, time limitations and lack of remuneration), process issues (e.g. researcher–general practice communication, researcher-imposed issues and need for partnerships) and content issues (e.g. study design, study procedures and methods). Conclusions: The consultations revealed similar ?ndings to previously published reports concerning general practice research, with an emphasis on the need for partnerships between researchers and general practice organizations in the conduct of such research.

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Evaluation of a mental health website for teenagers

Psychiatric Bulletin ◽

10.1192/pb.30.5.175 ◽

2006 ◽

Vol 30 (5) ◽

pp. 175-178 ◽

Cited By ~ 5

Author(s):

Sukru Ercan ◽

Andrew Kevern ◽

Leo Kroll

Keyword(s):

Mental Health ◽

Social Workers ◽

General Practitioners ◽

School Nurses ◽

The Self ◽

Clinical Implications ◽

Self Assessment ◽

Perceived Need ◽

Screening Questionnaires ◽

Assessment Questionnaire

Aim and MethodRu-ok.com is a recently developed website that includes a self-assessment questionnaire. The aim of this study was to evaluate the website and compare the self-assessment questionnaire with established screening questionnaires. A total of 105 teenagers from schools completed three paper-based questionnaires and the online ru-ok.com questionnaire.ResultsThe website receives 730 visits a week. Visits to the advice section and stories about mental health and relationships account for 35% of activity. Of the returned questionnaires, 80% were positive about the website. There were modest and expected correlations between the website questionnaire (RU–OK) and the Mood and Feelings (MFQ) and Strength and Difficulties (SDQ) questionnaires.Clinical ImplicationsInternet-based self-assessment is feasible and acceptable to teenagers. Self-assessment of perceived need by teenagers may be a useful tool for tier one professionals, including teachers, general practitioners, school nurses, social workers and learning mentors.

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Training General Practitioners in the Psychoanalytical Aspects of Mental Health

Challenges of Psychoanalysis in the 21st Century ◽

10.1007/978-1-4615-1357-5_13 ◽

2001 ◽

pp. 101-110 ◽

Cited By ~ 2

Author(s):

José Guimón

Keyword(s):

Mental Health ◽

General Practitioners

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Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory

JMIR Mental Health ◽

10.2196/23660 ◽

2020 ◽

Vol 7 (10) ◽

pp. e23660

Author(s):

Markus W Haun ◽

Isabella Stephan ◽

Michel Wensing ◽

Mechthild Hartmann ◽

Mariell Hoffmann ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

General Practitioners ◽

Diffusion Of Innovations ◽

Significant Proportion ◽

The United States ◽

Diffusion Of Innovations Theory ◽

Early Adopters ◽

Adopter Categories

Background Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. Objective This mixed method preimplementation study aims to assess GPs’ intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). Methods Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. Results This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, P<.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. Conclusions A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.

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Processing and assessing psychiatric referrals

Psychiatric Bulletin ◽

10.1192/pb.18.8.480 ◽

1994 ◽

Vol 18 (8) ◽

pp. 480-482

Author(s):

Prakash Naik ◽

Alan Lee

Keyword(s):

Mental Health ◽

General Practitioners ◽

Time Delays ◽

Past History ◽

Mental Health Team ◽

Health Team ◽

The Third ◽

Significant Difference

Referrals from general practitioners to a sectorised mental health team were audited for time delays and quality over three months. A referrers' guide was then designed to reduce referral delays and improve their quality. This was sent to all GPs. Referrals were again audited over two three month periods. There was no significant difference between corresponding time delays in the three periods. Only one item, the presence or absence of past history, was significantly improved in the third period. These results and their implications are discussed.

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Systematic review protocol exploring the impact of the COVID-19 pandemic on the wellbeing of general practitioners

10.1101/2021.08.05.21261627 ◽

2021 ◽

Author(s):

Laura Jefferson ◽

Su Golder ◽

Veronica Dale ◽

Holly Essex ◽

Elizabeth McHugh ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Quality Assessment ◽

General Practitioners ◽

Systematic Reviews ◽

Assessment Tools ◽

Systematic Review Protocol ◽

Health And Wellbeing ◽

Review Protocol ◽

The Impact

Background Over recent years chronic stress and burnout have been reported by doctors working in general practice in the UK NHS and internationally. The COVID-19 pandemic has changed general practitioners working lives; adding potential pressures from avoiding infection and addressing pent-up demand for care, but also changing processes such as rapidly taking up remote consultations. To date, there has been a focus on exploring the impact of the pandemic on the wellbeing of hospital clinicians. No registered systematic reviews currently focus on exploring the impact of the pandemic on the mental health and wellbeing of general practitioners. Aims and objectives To synthesise the current international evidence base exploring the impact of COVID-19 on the mental health and wellbeing of general practitioners, and which factors are associated with their reported mental health and wellbeing during the pandemic. Methods In this paper we report a systematic review protocol, following PRISMA guidance. In our search strategy we will identify primary research studies or systematic reviews exploring the mental health and wellbeing of general practitioners during the COVID-19 pandemic in four databases (MEDLINE, Embase, PsychInfo and Medrxiv) and Google Scholar. We will hand-search reference lists and grey literature. Two reviewers will undertake all stages including study selection, data extraction and quality assessment, with arbitration by a third reviewer where necessary. We will use standardised quality assessment tools to ensure transparency and reduce bias in quality assessment. Depending on the quality of included studies, we may undertake a sensitivity analysis by excluding studies from narrative synthesis that are rated as low quality using the checklists. We will describe the findings across studies using narrative thematic data synthesis, and if sufficiently homogenous data are identified, we will pool quantitative findings through meta-analysis.

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