Cited by 340Psychiatric care and mental health servicesMental Health Treatment and AccessPrimary Care and Health Outcomes

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Patients' and health professionals' views on primary care for people with serious mental illness: focus group study

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Lester, Helen, Tritter, Jonathan Q, Sorohan, Helen·2005·BMJ

DOI 10.1136/bmj.38440.418426.8fPMC PMC557894

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Abstract

OBJECTIVE: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. DESIGN: Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. SETTING: Six primary care trusts in the West Midlands. PARTICIPANTS: Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. RESULTS: Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and preferred to consult their own GP, who listened and was willing to learn, rather than be referred to a different GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. CONCLUSIONS: Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

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“…for people with mental illness improve in primary care, outcomes for common mental health problems (e.g. anxiety, depression) are equivalent to those in specialist services and people with mental health problems prefer receiving care from their GPs (Lester et al., 2005; Lester & Gask, 2006).”
Background
Predictors of health services utilization among persons with psychiatric disabilities engaged in supported independent housing.
Nath, S. B., Wong, Y.-L. I., Marcus, S. C., & Solomon, P. (2012) · Psychiatric Rehabilitation Journal · doi:10.2975/35.4.2012.315.323 · Cited by 9
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Gender and Mental Health
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MEDICINES INFORMATION SOURCES AND SERVICES FOR CONSUMERS: A SPECIAL FOCUS ON THE INTERNET AND PEOPLE WITH DEPRESSION
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“23 The strategy of not seeking help because of past or expected discrimination in people with MHSUC has been well documented.”
Background
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Cuddeback, G. S., & MORRISSEY, J. P. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.031 · Cited by 9
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Integrated Care and the Behavioral Health Home
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“These anecdotal reports by clients are consistent with other findings in the literature for why those with SMI have difficulties engaging with primary care (Lester et al., 2005).”
Result
Stroke survivors with severe mental illness: Are they at-risk for increased non-psychiatric hospitalizations?
Lilly, F. R. W., Culpepper, J. W., Stuart, M. E., & Steinwachs, D. M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0182330 · Cited by 8
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Gask, L. L., Kendrick, T., Peveler, R., & Chew-Graham, C. A. (2018) · Cambridge University Press eBooks · doi:10.1017/9781911623038.002 · Cited by 8
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Hardy, S., & Huber, J. (2014) · Primary Health Care · doi:10.7748/phc2014.03.24.3.18.e851 · Cited by 8
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Background
Patient and Physician Factors Associated with First Diagnosis of Non-affective Psychotic Disorder in Primary Care
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Whitley, R., Palmer, V. J., & Gunn, J. M. (2015) · British Journal of General Practice · doi:10.3399/bjgp15x686305 · Cited by 7
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Chuttoo, L., & Chuttoo, V. (2019) · Nursing Standard · doi:10.7748/ns.2019.e11331 · Cited by 7
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Folker, A. P., Kristensen, M. M., Kusier, A. O., Nielsen, M. B. D., Lauridsen, S., & Sølvhøj, I. N. (2019) · Qualitative Health Research · doi:10.1177/1049732319840286 · Cited by 7
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“…perspectives, enabled providers to approach patients in an individualised way based on their needs [69, 78], while patients reported that knowing their PCP allowed them to engage more actively in their own care, thus, promoting shared decision-making and improving experiences of care [28, 68].”
Influential
Revisión sobre la Utilización de Servicios de Salud, 1996-2006
Ruiz-Rodríguez, M., & Valdez‐Santiago, R. (2008) · Revista de Salud Pública · doi:10.1590/s0124-00642008000200014 · Cited by 6
“Así, por ejemplo, Lester (33), identifica como una de sus categorías de análisis a las tensiones entre las perspectivas de los pacientes y médicos, sobre lo que es la enfermedad mental y su tratamiento.”
BackgroundInfluential
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Lumby, B. (2007) · The Nurse Practitioner · doi:10.1097/01.npr.0000279569.16442.ca · Cited by 6

Authors: Lester, H., Tritter, J. Q., & Sorohan, H.
Affiliations: University of Birmingham (GB)
University of Warwick (GB)
University College Birmingham (GB)
ORCID: Tritter, Jonathan Q
Venue: BMJ
Publisher: BMJ
Published: 2005-04-20
Volume: 330
Issue: 7500
Pages: 1122
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.38440.418426.8f
PMC: PMC557894
OpenAlex: W1822286663
Cited by: 339
References: 29
Citations by year: 2026: 5 · 2025: 5 · 2024: 6 · 2023: 11 · 2022: 5 · 2021: 18 · 2020: 11 · 2019: 15 · 2018: 28 · 2017: 52 · 2016: 13 · 2015: 20 · 2014: 21 · 2013: 15 · 2012: 32
FWCI: 12.34
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
Locations: BMJ (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
HighWire Press Open Archive (submittedVersion)
Research Explorer (The University of Manchester) (submittedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
Keywords: severe mental illness, primary care, patient perspectives, health professional perspectives, general practitioners, practice nurses, health care access, waiting time, symptom exaggeration, secondary care referral, continuity of care, listening skills
MeSH terms: Adolescent, Adult, Aged, Attitude of Health Personnel, Attitude to Health, Mental Disorders, Chronic Disease, Female, Health Services Accessibility, Humans, Male, Middle Aged, Nurse Practitioners, Physicians, Family, Primary Health Care, Focus Groups

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Patients' and health professionals' views on primary care for people with serious mental illness: focus group study

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