Challenges and Complexities in Managing Distress in Primary Care: A Qualitative Study of Practitioner Experiences
Problem
People often present to primary care experiencing emotional distress. However distress c an be difficult to distinguish from psychological disorder (e.g. anxiety and depression). There may be important differences in the care provision needed for people where distress does not reflect psychopathology. Currently, the nature of assessment, and the care provided for people presenting with distress to primary care is unclear.
Approach
We are conducting remote online video interviews with up to 30 practitioners from a range of roles in primary care (including General Practitioners (GPs), Nurse Practitioners, Social Prescribers, and Mental Health Practitioners) about their experiences managing distress in primary care. The interview schedule explores practitioners’ views of distress and other mental health problems (including how these might be distinguished from each other), experiences of consulting people who present with distress, and the support they provide for people with distress. Practices are being recruited via two Clinical Research Networks in England. Practitioners are being recruited through a digital poster circulated by their practice or through ‘snowballing’ methods. Participants are purposively sampled with regards to their role, their experience, if the practice is in an area of high multiple deprivation, and whether the participant has an interest or specialist training in mental health. Interviews are recorded and transcribed verbatim. Analysis follows an inductive thematic approach.
Findings
We are conducting remote online video interviews with up to 30 practitioners from a range of roles in primary care (including General Practitioners (GPs), Nurse Practitioners, Social Prescribers, and Mental Health Practitioners) about their experiences managing distress in primary care. The interview schedule explores practitioners’ views of distress and other mental health problems (including how these might be distinguished from each other), experiences of consulting people who present with distress, and the support they provide for people with distress. Practices are being recruited via two Clinical Research Networks in England. Practitioners are being recruited through a digital poster circulated by their practice or through ‘snowballing’ methods. Participants are purposively sampled with regards to their role, their experience, if the practice is in an area of high multiple deprivation, and whether the participant has an interest or specialist training in mental health. Interviews are recorded and transcribed verbatim. Analysis follows an inductive thematic approach.
Consequences
There is uncertainty from practitioners about the management of people experiencing distress in primary care, and practitioners face challenges in the management of distress. While patients are frequently referred or sign-posted to a range of other services, there is little communication with primary care about engagement or effectiveness for an individual patient. The findings will be used to inform the development of accessible care pathways for those experiencing distress as their primary concern.