TY - JOUR
AU - K. Berzins
AU - D. Christian
AU - G. Aspinall
AU - L. Hansford
AU - F. Thomas
A1 - 
AB - BACKGROUND: Deepening poverty in the UK is associated with high levels of antidepressant prescribing in economically deprived areas. Primary care practitioners often do not feel confident to address the socioeconomic causes of distress. The DeStress-II training programme was co-developed with primary care practitioners and people from low-income communities to improve consultations, but evidence of long-term sustainability is required. AIM: To explore practitioners' perspectives on sustained changes to practice one year after DeStress-II training. DESIGN & SETTING: Qualitative follow-up study in English primary care practices. METHOD: Semi-structured interviews with 30 multidisciplinary practitioners12 months post-training. Data were analysed using thematic analysis, framed by Normalisation Process Theory to explore the embedding of new practices. RESULTS: Practitioners reported that DeStress-II principles were generally retained, with sustained confidence in asking about patients' socioeconomic circumstances. Reported impacts included increased referrals to social prescribers, strengthened multi-disciplinary teamwork, and a perceived shift towards non-pharmacological alternatives. Training provided professional legitimisation for holistic care and reinforced existing values, although full normalisation was hindered by systemic challenges such as limited consultation times, language barriers and patient expectations around the prescribing of antidepressant medication. CONCLUSION: The DeStress-II training intervention facilitates the embedding of socioeconomic determinants of health into consultations, aligning with the ambitions of the 10 Year Health Plan and the NICE guidelines for Depression. While practitioners perceive a positive shift in practice maximising the benefits requires integrated care approaches which support broader community service networks.
AD - Applied Health Research hub, University of Lancashire, Preston, Lancashire PR1 2HE, UK kberzins@lancashire.ac.uk.; Applied Health Research hub, University of Lancashire, Preston, Lancashire PR1 2HE, UK.; Department for Health and Community Sciences, St Luke's Campus, University of Exeter, Exeter EX4 4QH, UK.
AN - 42215043
BT - BJGP Open
C5 - Healthcare Disparities; Education & Workforce
DA - 05/2026
DO - 10.3399/bjgpo.2026.0031
DP - NLM
ET - 20260529
JF - BJGP Open
LA - eng
N2 - BACKGROUND: Deepening poverty in the UK is associated with high levels of antidepressant prescribing in economically deprived areas. Primary care practitioners often do not feel confident to address the socioeconomic causes of distress. The DeStress-II training programme was co-developed with primary care practitioners and people from low-income communities to improve consultations, but evidence of long-term sustainability is required. AIM: To explore practitioners' perspectives on sustained changes to practice one year after DeStress-II training. DESIGN & SETTING: Qualitative follow-up study in English primary care practices. METHOD: Semi-structured interviews with 30 multidisciplinary practitioners12 months post-training. Data were analysed using thematic analysis, framed by Normalisation Process Theory to explore the embedding of new practices. RESULTS: Practitioners reported that DeStress-II principles were generally retained, with sustained confidence in asking about patients' socioeconomic circumstances. Reported impacts included increased referrals to social prescribers, strengthened multi-disciplinary teamwork, and a perceived shift towards non-pharmacological alternatives. Training provided professional legitimisation for holistic care and reinforced existing values, although full normalisation was hindered by systemic challenges such as limited consultation times, language barriers and patient expectations around the prescribing of antidepressant medication. CONCLUSION: The DeStress-II training intervention facilitates the embedding of socioeconomic determinants of health into consultations, aligning with the ambitions of the 10 Year Health Plan and the NICE guidelines for Depression. While practitioners perceive a positive shift in practice maximising the benefits requires integrated care approaches which support broader community service networks.
PY - 2026
SN - 2398-3795
ST - Sustaining poverty-aware mental health practice: evaluating the long-term impacts of DeStress-II
T1 - Sustaining poverty-aware mental health practice: evaluating the long-term impacts of DeStress-II
T2 - BJGP Open
TI - Sustaining poverty-aware mental health practice: evaluating the long-term impacts of DeStress-II
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.3399/bjgpo.2026.0031
VO - 2398-3795
Y1 - 2026
ER -