The research Project
The NHS is struggling and overburdened with a rising number of patients presenting to their GPs with mental health and psychosocial problems. Studies suggest that 1 in 4 people in the UK will experience a mental health problem in any given year(1) whilst patients’ psychosocial problems play a part in 20% of all consultations(2). On a global scale, mental health problems are one of the main causes of the overall disease burden worldwide(3).
In the current UK General Practice curriculum, we are being taught a patient-centred model of consultation designed to reveal and manage all underlying issues which might be contributing to a patient’s poor health, as it is known that there are strong links between physical and mental health problems. However, due to limitations such as time with a concurrent lack of emphasis on continued communication skill training, this model is often not achievable, demonstrated by stretched services and patient dissatisfaction.
Globally, many western health systems teach and strive towards a similar model of care but the number of people suffering and presenting to their doctor with mental health and psychosocial problems varies greatly. By spending time in unique global communities that lie within a western healthcare system but exhibit varying levels of mental health issues, I hope to explore and find some answers to the questions; how do the social structures and support networks of a community affect the number of people presenting to their doctor with psychosocial problems? and what are the most effective consultation elements for managing psychosocial complaints both in terms of doctor consultation style but also wider reaching strategies that highlight and support mental health problems in the community as well as promote wellbeing.
The research will have an ethnographic basis. I will live and work within each community, promoting acceptance and the best conditions to allow an intimate portrait of the in-context doctor-patient experience to emerge, resulting in a deeper understanding of that experience. Since the aim of the study is to obtain culturally specific information about the values, opinions, behaviours and social contexts of particular populations the flexibility of a qualitative research methodology will be employed. This will include focus groups as well as individual in-depth interviews and participant observation.
I will disseminate my findings to the wider medical community through article publication, a British Medical Journal blog and submission to the Vasca Da Gama Movement preconference and WONCA conference in 2017. The analysis and video footage of differing global communication skills will be used, as an educational tool in training workshops.
1.McManus S, Meltzer H, Brugha T, Bebbington P, Jenkins R Adult Psychiatric Morbidity in England 2007: results of a household survey. NHS Information Centre for Health and Social Care. [online] Available at: http://www.hscic.gov.uk/pubs/psychiatricmorbidityZatinge EM, Verhaak PF, 2. 2.Zatinge EM, Verhaak PFKerssens JJ, Bensing JM The workload of GPs: consultations of patients with psychological and somatic problems compared Br J Gen Pract. 2005 Aug;55(517):60914
3.1. 1Vos, T., et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study. The Lancet. 386 (9995). pp. 743-800.