GP follow-up after first diagnosing psychological problems among adolescents: a nationwide register-based study

Hetlevik, Øystein; Bjørnå, Christina Hagen; Lundring, Ina-Terese; Gjesdal, Sturla

doi:10.3399/bjgp18x699425

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…While follow-up is a recommended strategy for the management of depression and suicidality in primary care, 81 88 89 rates of follow-up by GPs after diagnosing a young person with a psychological problem have been shown to require improvement. 90 Active follow-up by GPs can provide an opportunity for further assistance, strengthen the therapeutic relationship and potentially mitigate isolation, hopelessness and increased vulnerability that can occur with disengagement. 81 Implications for practice Primary care services and GPs should deliver care for suicidality and self-harm in a way that is sensitive to young people's identified needs and preferences, and tailored to their developmental stage.…”

Section: Carementioning

confidence: 99%

Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives

et al. 2020

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ObjectivesGeneral practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people’s opinions and experiences related to GPs’ practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people’s perspectives. This study aimed to explore young people’s views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs.Design, setting and participantsTwo qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total (Mage = 20.67 years; range: 16–24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis.ResultsFive major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist—disliking the terms ‘risk’ and ‘risk assessment’, and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs’ attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations.ConclusionsOur study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.

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Section: Carementioning

confidence: 99%

Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives

et al. 2020

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“…Moreover, GPs serve as gate‐keepers to the specialist mental health services. Only one‐third of adolescents who have been diagnosed with mental health conditions are referred for secondary care, even though GPs provide limited follow‐up 26 . There is a significant gap between the services developed in theory by policymakers and what adolescents encounter in reality.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of the ideal healthcare services to meet adolescents' mental health needs: A qualitative study of adolescents' perspectives

Meldahl

Krijger

Andvik

et al. 2022

Health Expectations

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Introduction Despite increased focus on development of mental health services worldwide, many adolescents still hesitate to reach out to the services when they need them. This might be linked to the lack of adolescent involvement in the development of services. This study aimed to explore adolescents' perspectives on the ideal healthcare services to meet their mental health needs. Methods A two‐stage qualitative study was carried out to explore the perspectives of adolescents on the healthcare services to support their mental health. In the first stage, data from 295 adolescents attending a mental health seminar were analysed using qualitative content analysis. In the second stage, in‐depth perspectives of 10 adolescent coresearchers were gathered through self‐reflection and group discussions to further explore the categories developed in the first stage. Thematic analysis was used to develop the themes answering the research question. Ten adolescent coresearchers planned the study, collected and analysed data and authored the manuscript, with the support of a senior researcher. Results Five themes describe adolescents' perspectives on the ideal healthcare services to meet their mental health needs: (1) Culturally Sensitive and Responsive; (2) Communication of Information; (3) Easy Access; (4) Variety of Support; and (5) Consistency. Culturally Sensitive and Responsive services influenced all other themes. The themes describe suggestions for mental health service improvement, including how to manage the barriers that adolescents face to receive help from the mental health services. Discussion This study highlights the importance of culturally sensitive and responsive services. It raises the need for an expanded definition of culture going beyond nationality and ethnic background. Adolescents need flexible services that meet their individual mental health needs. This has implications for practitioners, educators, system organizers and researchers, who should also involve adolescents in planning, implementing and assessing the services. There is a need for a self‐learning system to continuously adapt to user feedback. Conclusion This study provides insight into adolescents' perspectives on the ideal mental health services. It offers suggestions for ways to improve services to better meet the individual mental health needs of adolescents. Additional research is needed to further develop and implement service changes, as well as to assess their acceptability, effectiveness, cost‐effectiveness and safety. Patient or Public Contribution This is a study lead by adolescents. Adolescent coresearchers have, with the support of a senior researcher, planned and carried out the study, collected and analysed data and authored the manuscript.

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GP follow-up after first diagnosing psychological problems among adolescents: a nationwide register-based study

Cited by 2 publications

References 25 publications

Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives

Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives

Characteristics of the ideal healthcare services to meet adolescents' mental health needs: A qualitative study of adolescents' perspectives

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