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Patients' and health professionals' views on primary care for people with serious mental illness : focus group study
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Lester, Helen, 1961-, Tritter, Jonathan Q., 1965- and Sorohan, Helen. (2005) Patients' and health professionals' views on primary care for people with serious mental illness : focus group study. BMJ, Vol.330 (No.7500). 1122-1126B. ISSN 0959-8146
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Official URL: http://dx.doi.org/10.1136/bmj.38440.418426.8F
Abstract
Objective To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting Six primary care trusts in the West Midlands. Participants Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and prefer-red to consult their own GP, who listened and was willing to learn, rather than be referred to a different,GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Social Sciences > Warwick Business School |
| Library of Congress Subject Headings (LCSH): | Primary care (Medicine) -- Great Britain, Mentally ill -- Care -- Great Britain, Physicians (General practice) -- Great Britain |
| Journal or Publication Title: | BMJ |
| Publisher: | BMJ Group |
| ISSN: | 0959-8146 |
| Date: | 20 April 2005 |
| Volume: | Vol.330 |
| Number: | No.7500 |
| Number of Pages: | 8 |
| Page Range: | 1122-1126B |
| Identification Number: | 10.1136/bmj.38440.418426.8F |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Funder: | Great Britain. Dept. of Health (DoH) |
| References: | 1 Bird L. The fundamental facts about mental illness. London: Mental Health Foundation, 1999. 2 Nazareth I, King M, Haines A. Care of schizophrenia in general practice. BMJ 1993;307:910. 3 Lang F, Johnstone E, Murray D. Service provision for people with schizophrenia. Role of the general practitioner. Br J Psychiatry 1997;171:165-8. 4 Kai J, Crosland A, Drinkwater C. Prevalence of enduring and disabling mental illness in the inner city. Br J Gen Pract 2000;50:922-4. 5 Brown S. Excess mortality of schizophrenia. A meta-analysis. Br J Psychiatry 1997;171:502-8. 6 Bindman J, Johnson S, Wright S, Szmukler G, Bebbington P, Kuipers E, et al. Integration between primary and secondary services in the care of the severely mentally ill: patients’ and general practitioners’ views. Br J Psychiatry 1997;171:169-74. 7 Rogers A, May C, Oliver D. Experiencing depression, experiencing the depressed: the separate worlds of patients and doctors. J Mental Health 2001;10:317-33. 8 Kendrick T, Sibbald B, Burns T, Freeling P. Role of general practitioners in care of the long term mentally ill patients. BMJ 1991;302:508-10. 9 Burns T, Greenwood N, Kendrick T, Garland C. Attitudes of general practitioners and community mental health team staff towards the locus of care for people with chronic psychotic disorders. Primary Care Psychiatry 2000;6:67-71. 10 Bailey D. What is the way forward for a user-led approach to the delivery of mental health services in primary care? J Mental Health 1997;6:101-5. 11 Rogers A, Pilgrim D. Experiencing psychiatry: users’ views of services. London: Macmillan Press, 1993. 12 Kai J, Crosland A. Perspectives of people with enduring mental ill health from a community-based qualitative study. Br J Gen Pract 2001;51:730-7. 13 Burgess RG. In the field: an introduction to field research. London: Routledge, 1991. 14 Bradley CP. Turning anecdotes in to data: the critical incident technique. Fam Pract 1992;9:98-103. 15 Silverman D. Interpreting qualitative data. Methods for analysing talk, text and interaction. London: Sage, 1997. 16 Barbour R, Kitzinger J. Developing focus group research. Politics, theory and practice. London: Sage, 1999. 17 Coulthard M. Introduction to discourse analysis. 2nd ed. London: Longman, 1998. 18 Department of Health. Guidelines for the appointment of general practitioners with special interests in the delivery of clinical services: mental health. London: DoH, 2003. 19 Royal College of General Practitioners. Profile of UK general practitioners. RCGP Information Sheet No 1. 2004. www.rcgp.org.uk/information/publications/information/ PDFInfo/01JUN04.pdf (accessed 18 Apr 2004). 20 Freeman G,Weaver T, Low J, de Jonge E. Promoting continuity of care for people with severe mental illness whose needs span primary, secondary and social care. A report for the NCCSDO. London: National Co-ordinating Centre for NHS Service Delivery and Organisation R & D, 2002. 21 Schegloff EA. Notes on conversational practice: formulating place. In: Sudnow D, ed. Studies in social interaction. New York: Free Press, 1972. 22 Jean Y. Inclusive intake screening: shaping medical problems into specialistappropriate cases. Sociology of Health and Illness 2004;26:385-410. 23 Pollock K, Grime J. Patients’ perceptions of entitlement to time in general practice consultations for depression: qualitative study. BMJ 2002;325:1431-3. 24 Harrison G, Hopper K, Craig T, Laska E, Siegel C, Wanderling J, et al. Recovery from psychotic illness: a 15- and 25-year international follow-up study. Br J Psychiatry 2001;178:506-17. |
| URI: | http://wrap.warwick.ac.uk/id/eprint/7086 |
Data sourced from Thomson Reuters' Web of Knowledge
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