GP perceptions of community-based children’s mental health services in Pennine Lancashire: a qualitative study

Abstract

BackgroundGP satisfaction with specialist Child & Adolescent Mental Health Services (CAMHS) is often reported as low in the UK, and internationally.AimTo explore GP perceptions of local children’s mental health services and to understand their experiences of a novel GP-attached Primary Mental Health Worker (PMHW) service.Design & settingQualitative research involving GPs in Pennine Lancashire.MethodSemi-structured face-to-face interviews of GPs (n = 9) were carried out. Thematic analysis was undertaken.ResultsThemes identified included: 1) The role of the GP: most GPs perceived their role to be signposting and referring patients with mental health issues to specialist services, rather than offering care directly; 2) Clarity on help available: GPs were unclear about specialist CAMHS referral criteria and alternative resources available. GPs experienced communication challenges with specialist CAMHS; 3) Getting advice and support: PMHWs enabled GPs to have informal discussions, and to seek advice about children. Some GPs felt they could recognise problems earlier and were able to access help more quickly; and 4) Development needs: some GPs felt they required increased training in supporting children with mental health problems, and identified a need for further collaboration with schools and specialist CAMHS.ConclusionThe study identified challenges that GPs face with accessing and utilising specialist CAMHS. GPs who had PMHWs based in their practices expressed increased satisfaction with these services. GP-attached PMHWs can potentially reduce the challenges faced by GPs in primary care by offering timely and accessible advice, and improving access to specialist CAMHS.

Barriers and facilitators to training delivery and subsequent implementation of a localised child and adolescent mental health initiative: a qualitative content analysis

“…Even GPs lack the expertise needed to both support and refer appropriately when it comes to mental health. These shortcomings have been acknowledged by GPs themselves [ 11 , 12 ], as well as CYP reporting that they do not feel comfortable approaching GPs for these reasons [ 13 – 15 ].…”

The effect of the Development and Well-Being Assessment as an adjunct to standard referral letters on referral decisions by child and adolescent mental health services — a randomized feasibility trial

“…In Denmark, referrals to CAMHS can be carried out by educational psychologist, caseworkers in social services, general practitioners (GPs), or other medical doctors. GPs are responsible for the majority of referrals to CAMHS in Denmark and many other countries (Hansen et al, 2021; Lambert et al, 2020). GP satisfaction with CAMHS is often reported as low due to challenges with accessing specialist help (Lambert et al, 2020) and referrals from GPs have been shown to be three times more likely to be rejected than referrals from other sources (Hinrichs et al, 2012).…”

“…GPs are responsible for the majority of referrals to CAMHS in Denmark and many other countries (Hansen et al, 2021; Lambert et al, 2020). GP satisfaction with CAMHS is often reported as low due to challenges with accessing specialist help (Lambert et al, 2020) and referrals from GPs have been shown to be three times more likely to be rejected than referrals from other sources (Hinrichs et al, 2012). Studies on interventions aimed at improving the referral process to CAMHS are therefore highly relevant.…”

Barriers and facilitators to training delivery and subsequent implementation of a localised child and adolescent mental health initiative: A qualitative content analysis

“…Even GPs lack the expertise needed to both support and refer appropriately when it comes to mental health. These shortcomings have been acknowledged by GPs themselves [11,12], as well as CYP reporting that they do not feel comfortable approaching GPs for these reasons [13][14][15].…”