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

Alice Kate Lambert,Umesh Chauhan,Alison Jayne Doherty,Neil Wilson,Dushyanthan Mahadevan

doi:10.3399/bjgpopen20x101075

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.

Highlights

The prevalence of mental disorders in children and young people is increasing nationally and internationally
Themes 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 Child & Adolescent Mental Health Services (CAMHS) referral criteria and alternative resources available
GPs who had Primary Mental Health Worker (PMHW) based in their practices expressed increased satisfaction with these services

Summary

Introduction

The prevalence of mental disorders in children and young people is increasing nationally and internationally. In the UK one in eight children (aged 5 to 19 years) have a mental disorder, in keeping with the worldwide prevalence of mental disorders in children and adolescents of 13.4%.2,3. This has implications for future adult mental health, as most adult mental disorders start in childhood.[4] The rising prevalence and future implications highlight the importance of prevention and early intervention for child and adolescent mental health problems.[5] There has been much attention recently on the role of schools in providing mental health support, both in British government policy and research studies.[5,6]. GP satisfaction with specialist Child & Adolescent Mental Health Services (CAMHS) is often reported as low in the UK, and internationally

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