scholarly journals GP views on their role in bullying disclosure by children and young people in the community: a cross-sectional qualitative study in English primary care

2019 ◽  
Vol 69 (688) ◽  
pp. e752-e759
Author(s):  
Laura Condon ◽  
Vibhore Prasad
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Young People ◽  
Qualitative Study ◽  
Health Concern ◽  
Health Consequences ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Children And Young People ◽  
Being Bullied

BackgroundBullying among children and young people (CYP) is a major public health concern that can lead to physical and mental health consequences. CYP may disclose bullying, and seek help from a GP. However, there is currently little research on GPs’ views on and perceptions of their role in dealing with disclosures of bullying in primary care.AimTo explore GPs’ views about their role in dealing with CYPs’ disclosures of being bullied, especially factors that have an impact on GPs’ roles.Design and settingIn this cross-sectional qualitative study, semi-structured interviews were conducted with GPs in primary care in England from October to December 2017.MethodPurposive sampling was used to achieve variation in GP age, professional status in practice, profile of the patients served by the practice, practice size and location, and whether the GPs considered themselves to be actively in research or teaching.ResultsData from 14 semi-structured interviews revealed three main themes: remaining clinically vigilant; impact of bullying in schools; and training and guidance on dealing with bullying and cyberbullying. GPs felt that dealing with disclosures of bullying and cyberbullying came down to their clinical experience rather than guideline recommendations, which do not currently exist, and that bullying was a precipitating factor in presentations of CYPs’ mental health issues.ConclusionGPs feel they have a role to play in managing and supporting the health of CYP who disclose being bullied during consultations. However, they feel ill-equipped to deal with these disclosures because of lack of professional development opportunities, and guidance on treating and managing the health consequences of being bullied.

scholarly journals GPs’ views about their role when children and young people disclose a history of bullying in the community: a qualitative study

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702953
Author(s):  
Vibhore Prasad ◽  
Laura Condon
Keyword(s):  
Mental Health ◽  
Young People ◽  
Comparative Method ◽  
Continuing Professional Development ◽  
Health Consequences ◽  
Physical And Mental Health ◽  
Structured Interviews ◽  
Children And Young People ◽  
History Of ◽  
Views And Perceptions

BackgroundBullying among children and young people (CYP) can lead to both physical and mental health consequences. CYP may disclose episodes of bullying and seek help from their GP. Therefore GPs have an important role in dealing with the mental and physical health consequences of bullying. However, there is currently little research on GPs’ views and perceptions on their role in dealing with bullying.AimTo explore GPs views about their role in dealing with disclosures of bullying by CYP.MethodSemi-structured interviews were conducted with GPs in England. Purposive sampling was used to achieve variation in GP demographics. Data were collected until thematic saturation was reached and analysed using the constant comparative method.ResultsData from 14 semi-structured interviews revealed three main themes: GP experience, bullying in schools and cyberbullying, and training needs. There was an encompassing feeling that dealing with disclosures of bullying came down to a GP’s clinical experience rather than guideline recommendations, which do not currently exist; and that bullying was a precipitating factor in presentations of CYP’s mental health issues. Continuing professional development opportunities are needed. Such opportunities should include both the nature and health consequences of bullying, including cyberbullying, for which GPs felt ill prepared but which was reported to affect their practice.ConclusionGPs feel they have a role to play in managing and supporting the health of CYP who disclose bullying. However, they feel ill equipped in dealing with these disclosures. There is a need for collaboration between GPs and education services to improve support.

scholarly journals Personality disorder co-morbidity in primary care ‘Improving Access to Psychological Therapy’ (IAPT) services: a qualitative study exploring patient perspectives on treatment experience

2020 ◽  
pp. 1-15
Author(s):  
Gary Lamph ◽  
John Baker ◽  
Tommy Dickinson ◽  
Karina Lovell
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Personality Disorder ◽  
Qualitative Study ◽  
Patient Group ◽  
Stepped Care ◽  
Research Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Co Morbidity

Abstract Background: High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England. Aims: This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment. Method: A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach. Results: Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important. Conclusions: For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

scholarly journals Podrška i pomoć obiteljima djece s teškoćama u razvoju

2017 ◽  
Vol 53 (1) ◽  
pp. 22-34
Author(s):  
Mia Lakatoš ◽  
Lucija Vejmelka
Keyword(s):  
Social Support ◽  
Young People ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Daily Activities ◽  
Therapy Dogs ◽  
Structured Interviews ◽  
Children And Young People ◽  
Lack Of Information ◽  
Emotional Social Support

Therapy dogs, which play a central role in animal-assisted therapy, are trained to support daily activities and promote development of children and young people with disabilities. This qualitative study involved semi structured interviews in September 2016 with seven parents of children with disabilities who use therapy dogs. The interview, which was designed specifically for the purposes of this study, collected data on the types of social support and assistance that the therapy dogs provided, as well as the challenges that the use of such dogs presented. Thematic analysis of the interviews showed that therapy dogs provide instrumental and emotional social support as well as other types of assistance to families, and that the greatest challenges to using such dogs are taking care of them and dealing with lack of information about therapy dogs among users and the general public.

scholarly journals Potential for Integrating Mental Health Specialist Video Consultations in Office-Based Routine Primary Care: Cross-Sectional Qualitative Study Among Family Physicians

10.2196/13382 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e13382 ◽  
Author(s):  
Mariell Hoffmann ◽  
Mechthild Hartmann ◽  
Michel Wensing ◽  
Hans-Christoph Friederich ◽  
Markus W Haun
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Study ◽  
Primary Care Practice ◽  
Family Physicians ◽  
Health Conditions ◽  
Care Practice ◽  
Cross Sectional ◽  
Mental Health Specialist ◽  
Health Specialist

Background Although real-time mental health specialist video consultations have been proposed as an effective care model for treating patients with mental health conditions in primary care, little is known about their integration into routine practice from the perspective of family physicians. Objective This study aimed to determine the degree to which family physicians advocate that mental health specialist video consultations can be integrated into routine primary care, where most patients with mental health conditions receive treatment. Methods In a cross-sectional qualitative study, we conducted 4 semistructured focus groups and 3 telephonic interviews in a sample of 19 family physicians from urban and rural districts. We conducted a qualitative content analysis applying the Tailored Implementation in Chronic Diseases framework in a combined bottom-up (data-driven) and top-down strategy for deriving key domains. Results Family physicians indicated that mental health specialist video consultations are a promising and practical way to address the most pressing challenges in current practice, that is, to increase the accessibility and co-ordination of specialized care. Individual health professional factors were the most frequently discussed topics. Specifically, family physicians valued the anticipated clinical outcomes for patients and the anticipated resources set for the primary care practice as major facilitators (16/19, 84%). However, family physicians raised a concern regarding a lack of facial expressions and physical interaction (19/19, 100%), especially in emergency situations. Therefore, most family physicians considered a viable emergency plan for mental health specialist video consultations that clearly delineates the responsibilities and tasks of both family physicians and mental health specialists to be essential (11/19, 58%). Social, political, and legal factors, as well as guideline factors, were hardly discussed as prerequisites for individual family physicians to integrate mental health specialist video consultations into routine care. To facilitate the implementation of future mental health specialist video consultation models, we compiled a checklist of recommendations that covers (1) buy-in from practices (eg, emphasizing logistical and psychological relief for the practice), (2) the engagement of patients (eg, establishing a trusted patient-provider relationship), (3) the setup and conduct of consultations (eg, reliable emergency plans), and (4) the fostering of collaboration between family physicians and mental health specialists (eg, kick-off meetings to build trust). Conclusions By leveraging the primary care practice as a familiar environment for patients, mental health specialist video consultations provide timely specialist support and potentially lead to benefits for patients and more efficient processes of care. Integration should account for the determinants of practice as described by the family physicians. Trial Registration German Clinical Trials Register DRKS00012487; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012487

scholarly journals A Family-Focused Intervention for Parental Mental Illness: A Practitioner Perspective

2021 ◽  
Vol 12 ◽  
Author(s):  
Mairead Furlong ◽  
Christine Mulligan ◽  
Sharon McGarr ◽  
Siobhan O'Connor ◽  
Sinead McGilloway
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Qualitative Study ◽  
Child Protection ◽  
Service Providers ◽  
Controlled Trial ◽  
Parental Mental Illness ◽  
Structured Interviews ◽  
Mental Health Settings

Background: Parental mental illness (PMI) is common and can lead to children developing mental disorders. Family Talk (FT) is a well-known and widely implemented intervention designed to reduce the risk of transgenerational psychopathology. However, given the research to practise “gap,” very little qualitative research, to date, has investigated practitioner experiences in implementing FT. This study aimed to explore the practitioner-perceived barriers and facilitators to the implementation and sustainability of FT within mainstream mental health settings.Methods: This qualitative study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] within 15 adult (AMHS), child (CAMHS), primary care mental health, and child protection sites in Ireland. Semi-structured interviews and focus groups were undertaken with a purposive sample of clinicians (n = 31) and managers (n = 10), based on their experiences of implementing FT. Interview data were transcribed verbatim, analysed using constructivist grounded theory, and informed by Fixsen's implementation science framework.Results: Service providers highlighted a number of benefits for approximately two thirds of families across different diagnoses and mental health settings (AMHS/CAMHS/primary care). Sites varied in their capacity to embed FT, with key enablers identified as acquiring managerial and organisational support, building clinician skill, and establishing interagency collaboration. Implementation challenges included: recruitment difficulties, stresses in working with multiply-disadvantaged families, disruption in delivery due to the COVID-19 global pandemic, and sustainability concerns (e.g., perceived fit of FT with organisational remit/capacity, systemic and cultural barriers to change).Conclusion: This study is only the second qualitative study ever conducted to explore practitioner experiences in implementing FT, and the first conducted within the context of an RCT and national research programme to introduce family-focused practise (FFP) for families living with PMI. The findings illuminate the successes and complexities of implementing FFP in a country without a “think family” infrastructure, whilst highlighting a number of important generalisable lessons for the implementation of FT, and other similar interventions, elsewhere.

scholarly journals What is the prevalence, and what are the clinical correlates, of insulin resistance in young people presenting for mental health care? A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025674 ◽  
Author(s):  
Elizabeth M Scott ◽  
Joanne S Carpenter ◽  
Frank Iorfino ◽  
Shane P M Cross ◽  
Daniel F Hermens ◽  
...  
Keyword(s):  
Mental Health ◽  
Insulin Resistance ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Self Report ◽  
Model Assessment ◽  
Cross Sectional ◽  
Younger Age

ObjectivesTo report the distribution and predictors of insulin resistance (IR) in young people presenting to primary care-based mental health services.DesignCross-sectional.SettingHeadspace-linked clinics operated by the Brain and Mind Centre of the University of Sydney.Participants768 young people (66% female, mean age 19.7±3.5, range 12–30 years).Main outcome measuresIR was estimated using the updated homeostatic model assessment (HOMA2-IR). Height and weight were collected from direct measurement or self-report for body mass index (BMI).ResultsFor BMI, 20.6% of the cohort were overweight and 10.2% were obese. However, <1% had an abnormally high fasting blood glucose (>6.9 mmol/L). By contrast, 9.9% had a HOMA2-IR score >2.0 (suggesting development of IR) and 11.7% (n=90) had a score between 1.5 and 2. Further, there was a positive correlation between BMI and HOMA2-IR (r=0.44, p<0.001). Participants in the upper third of HOMA2-IR scores are characterised by younger age, higher BMIs and depression as a primary diagnosis. HOMA2-IR was predicted by younger age (β=0.19, p<0.001) and higher BMI (β=0.49, p<0.001), together explaining 22% of the variance (F(2,361)=52.1, p<0.001).ConclusionsEmerging IR is evident in a significant subgroup of young people presenting to primary care-based mental health services. While the major modifiable risk factor is BMI, a large proportion of the variance is not accounted for by other demographic, clinical or treatment factors. Given the early emergence of IR, secondary prevention interventions may need to commence prior to the development of full-threshold or major mood or psychotic disorders.

scholarly journals Managing orthodontic appliances in everyday life: A qualitative study of young people’s experiences with removable functional appliances, fixed appliances and retainers

2020 ◽  
Vol 47 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Jennifer E Kettle ◽  
Amy C Hyde ◽  
Tom Frawley ◽  
Clare Granger ◽  
Sarah J Longstaff ◽  
...  
Keyword(s):  
Young People ◽  
Qualitative Study ◽  
Everyday Life ◽  
Social Process ◽  
The Body ◽  
Orthodontic Appliances ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Cross Sectional ◽  
Orthodontic Patients

Objective: To compare young people’s experiences of wearing a range of orthodontic appliances. Design: A cross-sectional, qualitative study with purposive sampling. Setting: UK dental teaching hospital. Participants: Twenty-six orthodontic patients aged 11–17 years. Methods: Patients participated in in-depth semi-structured interviews. All interviews were transcribed verbatim and analysed thematically. Results: Young people reported physical, practical and emotional impacts from their appliances. Despite these reported impacts, participants described ‘getting used’ to and, therefore, not being bothered by their appliance. Framework analysis of the data identified a multi-dimensional social process of managing everyday life with an appliance. This involves addressing the ‘dys-appearance’ of the body through physically adapting to an appliance. This process also includes psychological approaches, drawing on social networks, developing strategies and situating experiences in a longer-term context. Engaging in this process allowed young people to address the physical, practical and emotional impacts of their appliances. Conclusion: This qualitative research has identified how young people manage everyday life with an appliance. Understanding this process will help orthodontists to support their patients.

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