Mental health in general practice: GP perspectives and exploration of a clinical psychology pilot initiative

Abstract
Background: GPs provide a high proportion of consultations for patients presenting with mental health difficulties; however, they have little formal training in this area.
Aims: To explore the existing literature concerning GPs’ experience of working with patients presenting with mental health difficulties, particularly focussing on GPs’ emotional responses.
Method: PsycINFO, Medline, EMBASE, CINAHL, Scopus and EThOS were searched. Key inclusion criteria included: conducted in a UK setting; no earlier than 2004. After screening by title, abstract and full paper, common themes across studies were generated through narrative analysis. Quality was appraised using the Critical Appraisal Skills Programme for qualitative research checklist.
Results: Fifteen articles were included in the analysis. Common themes included feelings of uncertainty and anxiety, perceived professional incompetence and disempowerment, scepticism and dread, hopelessness, frustration, and burden and responsibility. Methodological limitations in both the reviewed literature and current review are highlighted for context.
Conclusions: GPs appear to experience working with patients presenting with mental health difficulties as testing. In light of the current proportion of GP workload that relates to mental health, this is concerning. Support may be provided through improved communication and collaboration with specialist services, as well as enhanced training.