General practitioners' perceptions of mental health services and factors influencing their referral decisions: a comparative, qualitative study

Maddicks, Richard Lee (1996). General practitioners' perceptions of mental health services and factors influencing their referral decisions: a comparative, qualitative study. PhD thesis The Open University.

DOI: https://doi.org/10.21954/ou.ro.0000e122

Abstract

This study provides a rationale for using a qualitative methodology to explore the factors which influence the GP to refer patients to mental health services. Referral data for a 12 month period were collected and a semi-structured interview used with five male and five female GPs. Findings indicated the importance of inaccessibility in influencing how mental health services were used and suggested that GPs adopt different strategies to manage difficulties associated with this. Clinical psychologists were perceived as inaccessible by all participants whilst their-role was generally defined in a very limited way, with reference to behavioural management skills. In-practice mental health professionals were used extensively and valued due to ease of access, increased opportunities for direct communication and reduced stigma for the patient. Comparative analysis suggested that, generally, female GPs placed more emphasis on the doctor-patient patient relationship and there was an increased likelihood of the female GP perceiving the management of mental health problems as part of their role. Further research questions are considered and methodological issues addressed. The implications of the findings for the relationship between clinical psychology and general practice are discussed.