Abstract
BackgroundEarly intervention in people with an at-risk mental state for psychosis can decrease the rates of transition to psychosis. GPs play a key role in the identification of this patient group but very few studies have explored GPs’ awareness of patients who are at risk of psychosis.AimTo explore GPs’ views and experiences of identifying patients with an at-risk mental state for psychosis, and the barriers and facilitators to identification.Design and settingIn-depth semi-structured interviews were held with GPs working in South West England primary care. The interviews were conducted between March and July 2019.MethodA topic guide was used to ensure consistency across interviews. This guide was revised to incorporate a definition of the at-risk mental state for psychosis, as after conducting a few interviews it became clear that some GPs were not familiar with this construct. Interviews were audiorecorded and analysed thematically.ResultsA total of 20 GPs were interviewed. Some GPs were not familiar with the concept of being at risk of developing psychosis, and perceived that they may not have the right skills to identify this patient group. Other barriers related to patients not presenting or disclosing psychotic symptoms, and limitations imposed by scarce resources on the structure and provision of NHS services, such as lack of continuity of care and high thresholds for accessing specialised services.ConclusionIdentifying people at risk of psychosis in primary care is difficult. Provision of GP training, development of policies that support continuity of care, and improved access to specialised services could help improve the identification of this patient group.
Highlights
Psychotic illnesses are one of the leading causes of disability worldwide.[1,2] The outcome of psychotic illnesses is poor, with most people never making a full recovery.[3]
Other barriers related to patients not presenting or disclosing psychotic symptoms, and limitations imposed by scarce resources on the structure and provision of NHS services, such as lack of continuity of care and high thresholds for accessing specialised services
Provision of GP training, development of policies that support continuity of care, and improved access to specialised services could help improve the identification of this patient group
Summary
Psychotic illnesses are one of the leading causes of disability worldwide.[1,2] The outcome of psychotic illnesses is poor, with most people never making a full recovery.[3] Yet it is possible to identify those at high risk of developing psychosis using validated criteria and psychometric instruments.[4] This is important as early intervention can reduce rates of transition to psychosis by approximately 50%.5–8. National Institute for Health and Care Excellence guidelines recommend cognitive behavioural therapy (CBT) for people with an at-risk mental state for psychosis,[9] but non-specific interventions, such as supportive psychotherapy focusing on social relationships or family problems, may help.[10,11]. Intervention in people with an at-risk mental state for psychosis can decrease the rates of transition to psychosis. GPs play a key role in the identification of this patient group but very few studies have explored GPs’ awareness of patients who are at risk of psychosis
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have