Lambert Alice Kate, Doherty Alison Jayne, Wilson Neil, Chauhan Umesh, Mahadevan Dushyanthan
Child & Adolescent Mental Health Services, Bradford District Care NHS Foundation Trust, Saltaire, UK
Faculty of Health & Wellbeing, University of Central Lancashire, Preston, UK.
BJGP Open. 2020 Oct 27;4(4). doi: 10.3399/bjgpopen20X101075. Print 2020 Oct.
GP satisfaction with specialist Child & Adolescent Mental Health Services (CAMHS) is often reported as low in the UK, and internationally.
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.
Semi-structured face-to-face interviews of GPs ( = 9) were carried out. Thematic analysis was undertaken.
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.
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.
在英国及国际上，全科医生（GP）对儿童与青少年心理健康服务（CAMHS）专科服务的满意度通常较低。
探讨全科医生对当地儿童心理健康服务的看法，并了解他们对一项新型的附属于全科医生的初级心理健康工作者（PMHW）服务的体验。
对兰开夏郡奔宁地区的全科医生进行定性研究。
对9名全科医生进行半结构化面对面访谈，并进行主题分析。
确定的主题包括：1）全科医生的角色：大多数全科医生认为他们的角色是为有心理健康问题的患者提供指引并转诊至专科服务，而非直接提供护理；2）可获得帮助的清晰度：全科医生不清楚儿童与青少年心理健康服务专科转诊标准及可用的替代资源。全科医生在与儿童与青少年心理健康服务专科进行沟通时遇到挑战；3）获取建议与支持：初级心理健康工作者使全科医生能够进行非正式讨论，并就儿童问题寻求建议。一些全科医生觉得他们能够更早地识别问题，并能更快地获得帮助；4）发展需求：一些全科医生觉得他们需要在支持有心理健康问题的儿童方面接受更多培训，并认为有必要与学校及儿童与青少年心理健康服务专科进一步合作。
该研究确定了全科医生在获取和利用儿童与青少年心理健康服务专科服务时面临的挑战。在其诊所配备初级心理健康工作者的全科医生对这些服务的满意度有所提高。附属于全科医生的初级心理健康工作者通过提供及时且可获取的建议以及改善获得儿童与青少年心理健康服务专科服务的机会，有可能减少全科医生在初级保健中面临的挑战。
