Discussing poverty within primary care consultations: implications for mental health support

在初级保健咨询中讨论贫困问题:对心理健康支持的影响

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Abstract

BACKGROUND: Poverty can have significant impacts on health and wellbeing. However, asking patients about their broader socioeconomic circumstances is not routine within primary care consultations. AIM: To understand healthcare professionals' experiences of communicating with patients about their socioeconomic circumstances and how a bespoke training programme supported these conversations in routine consultations. DESIGN & SETTING: Healthcare professionals from 30 GP practices across England received training to improve understanding and communication with patients about the ways that poverty impacted their mental health. METHOD: Semi-structured interviews were undertaken with 49 GPs and allied health professionals to understand barriers and enablers to communication around poverty and the impact of the training on their consultation practice. RESULTS: Health professionals often lacked confidence in discussing socioeconomic issues and welcomed information on how to do this sensitively. Asking questions about poverty-related stresses was felt to lead to better understanding of the causes of mental distress, avoidance of problematic assumptions and inappropriate antidepressant prescribing, and to enable more coordinated and appropriate support from practice teams. CONCLUSION: Asking patients about their socioeconomic circumstances can facilitate provision of appropriate support.

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