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

BJGP Open. 2020 Oct 27;4(4):bjgpopen20X101075. doi: 10.3399/bjgpopen20X101075. Print 2020 Oct.

Abstract

Background: GP satisfaction with specialist Child & Adolescent Mental Health Services (CAMHS) is often reported as low in the UK, and internationally.

Aim: To 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 & setting: Qualitative research involving GPs in Pennine Lancashire.

Method: Semi-structured face-to-face interviews of GPs (n = 9) were carried out. Thematic analysis was undertaken.

Results: 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 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.

Conclusion: The 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.

Keywords: Child health; Mental health; Mental health services; Primary health care; Referral and consultation.