Abstract
BACKGROUND: Access to timely mental healthcare relies on patients' descriptions of their mental health problems. We therefore sought to better understand, from the patients' perspective, how they communicate their need for specialised mental healthcare to their GPs or mental health specialists and what factors affect communication when patients are referred from their GPs to specialised mental healthcare. METHODS: This was an exploratory interview study. Ten adults who started treatment in specialised mental healthcare facilities were interviewed individually. The interviews were audiotaped and transcribed verbatim. A method based on thematic analysis was used to develop patterns and themes within the dataset using an iterative inductive approach, with checks for internal consistency throughout. RESULTS: Three typical personal approaches - or styles - of communicating needs could be generated. These approaches varied in how active the patients were in their help-seeking, how unrestrictedly they communicated their health concerns and their receptiveness to input from healthcare professionals. Relevant factors affecting the communication were the characteristics of the healthcare services; the responses of others; fear of rejection and misunderstanding; health literacy and experience with mental healthcare; taking responsibility for one's own treatment; and the mental health problem itself. CONCLUSIONS: The different patient approaches to getting help for mental health problems and how those approaches are affected by individual, contextual and system factors highlight the need for individualised and welcoming communication by care providers. The current study contributes with useful insights from the patient's perspective into how e.g. the patient's previous experiences and understanding of the healthcare system influences the process of seeking help from a GP and being referred to specialist mental health services.