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How do GP registrars feel about dealing with mental health issues in the primary care setting? A qualitative investigation

The treatment of mental health problems is now a national priority in the UK. With a prevalence rate of 23% in the general population and 75% of the population visiting a GP each year, the role of primary care in the detection, management and treatment of mental health problems is pivotal. However, around 20% of mental health problems remain unidentified by GPs. Many reasons may contribute to this. One reason is cited as being the training received by GPs, although research into this has yielded inconclusive results. This study aimed to investigate qualitatively the attitudes of GP registrars, firstly towards dealing with mental health problems in primary care and secondly in relation to the training and support received. Sixteen semistructured interviews were conducted and analysed thematically. Results indicated that GP registrars in this study understood the psychosocial nature of mental health problems and felt confident in detecting these issues in their patients. However, they were less secure about the management of mental health problems due to a number of constraints such as inadequate time, lack of knowledge of referral pathways and local resources, and a limited understanding of the psychology of mental health problems. They appreciated the support provided by their trainers, the training practices and the vocational training scheme (VTS). They would benefit from additional input concerning assessment and management of psychological problems, and discussions around their new role as a GP, acknowledging its potentials and limitations.