TY - JOUR
AU - P. Oliver
AU - V. Huddy
AU - C. McInerney
AU - A. Achinanya
AU - M. Horspool
AU - K. Dwivedi
AU - C. Burton
A1 - 
AB - Background Complex Mental Health Difficulties (CMHD) describes long-term difficulties with emotional regulation and relationships, including personality disorders, complex trauma and dysthymia. People with CMHD often experience episodic and crisis-related care. Aim To understand how general practices can better recognise people with CMHDs and provide the best care. Design and Setting A concurrent mixed-methods study was conducted with three components: two qualitative studies and a database study. Methods PPIE People with lived experience of CMHD were consulted throughout the study. Qualitative interviews with GPs and people with CMHD were conducted and transcripts analysed using thematic analysis. Database study A retrospective case-control analysis was conducted using the Connected Bradford database. Integration of results was conducted using 'following the thread' and triangulation methods. Results GP interviews: Four overarching themes were identified: (1) The challenges of CMHD; (2) Role expectations; (3) Fragmented communication, fragmented care; (4) Treatment in the primary care context. Lived experience interviews: Four main themes were identified: (1) "How I got here"; (2) Varied care experiences; (3) Traversing mental health services; (4) "Being Seen". Database study: Approximately 3,040 (0.3% of the database population) records met our criteria for CMHD, suggesting significant under-coding. The most informative feature was the count of unique psychiatric diagnoses. Triangulation: Five meta-themes were identified (i) Complexity of mental health difficulties; (ii) Experience of trauma; (iii) Diagnosis; (iv) Specialist services; and (v) GP services. Conclusion The current organisation of care and lack of an acceptable language for CMHD means that patients' needs continue to go unrecognised and "unseen".
AD - The University of Sheffield, Sheffield, United Kingdom.; The University of Sheffield, Clinical Psychology, Sheffield, United Kingdom.; Sheffield Health and Social Care NHS Foundation Trust, Sheffield, United Kingdom.; University of Sheffield Faculty of Medicine Dentistry and Health, Sheffield, United Kingdom chris.burton@sheffield.ac.uk.
AN - 40473433
BT - Br J Gen Pract
C5 - Education & Workforce; Healthcare Disparities
DA - Jun 5
DO - 10.3399/bjgp.2024.0818
DP - NLM
ET - 20250605
JF - Br J Gen Pract
LA - eng
N2 - Background Complex Mental Health Difficulties (CMHD) describes long-term difficulties with emotional regulation and relationships, including personality disorders, complex trauma and dysthymia. People with CMHD often experience episodic and crisis-related care. Aim To understand how general practices can better recognise people with CMHDs and provide the best care. Design and Setting A concurrent mixed-methods study was conducted with three components: two qualitative studies and a database study. Methods PPIE People with lived experience of CMHD were consulted throughout the study. Qualitative interviews with GPs and people with CMHD were conducted and transcripts analysed using thematic analysis. Database study A retrospective case-control analysis was conducted using the Connected Bradford database. Integration of results was conducted using 'following the thread' and triangulation methods. Results GP interviews: Four overarching themes were identified: (1) The challenges of CMHD; (2) Role expectations; (3) Fragmented communication, fragmented care; (4) Treatment in the primary care context. Lived experience interviews: Four main themes were identified: (1) "How I got here"; (2) Varied care experiences; (3) Traversing mental health services; (4) "Being Seen". Database study: Approximately 3,040 (0.3% of the database population) records met our criteria for CMHD, suggesting significant under-coding. The most informative feature was the count of unique psychiatric diagnoses. Triangulation: Five meta-themes were identified (i) Complexity of mental health difficulties; (ii) Experience of trauma; (iii) Diagnosis; (iv) Specialist services; and (v) GP services. Conclusion The current organisation of care and lack of an acceptable language for CMHD means that patients' needs continue to go unrecognised and "unseen".
PY - 2025
SN - 0960-1643
ST - Complex mental health difficulties: a mixed methods study in primary care
T1 - Complex mental health difficulties: a mixed methods study in primary care
T2 - Br J Gen Pract
TI - Complex mental health difficulties: a mixed methods study in primary care
U1 - Education & Workforce; Healthcare Disparities
U3 - 10.3399/bjgp.2024.0818
VO - 0960-1643
Y1 - 2025
ER -