Severe mental illness patients and their carers’ expectations for general practitioners’ communication skills: a qualitative approach in Spain

Background Effective Communication with General Practitioners (GPs) provides higher rates of satisfaction and adherence to treatment plans. People with Severe Mental Illness (SMI) and their caregivers present unique characteristics that present difficulties in the GP-carer-patient communication process.

Aim To explore SMI patients and their caregivers’ expectations for GPs’ Communication Skills (CS) in primary care (PC) consultations.

Design & setting Face-to-face interviews using focus group methodology surveyed in southern Spain.

Method 42 participants in 21 paired semi-structured interviews with an average duration of 19±7.2 minutes. Information was audio-recorded and transcribed literally. Qualitative content analysis, obtaining a codification in categories by means of triangulation.

Results The ability of GPs to use a language that was colloquial and adapted to each person was perceived as a determinant of the quality of care provided. An empathetic attitude, low reactivity and efficient time management were the most valued CS. The telephone consultation was perceived as a useful tool to care for people with SMI. Video consultation was valued as a requirement in isolated rural areas. The caregiver was considered by the patients as an allie who improves the clinical interview. Finally, the continuity of care, defined by a low turnover of GPs, determined the quality perceived by those who require care.

Conclusion Themes emerging from this study suggest that people suffering from SMI require an inclusive, collaborative and personalised approach in the care they receive from the public health system. Improved communication between general practitioners and patients with SMI is an essential requirement for quality medical care.