GPs’ and patients’ views on recovery from psychosis
| Date | 03 June 2014 |
| Pages | 99-109 |
| Published date | 03 June 2014 |
| DOI | https://doi.org/10.1108/MHRJ-11-2013-0035 |
| Author | Seamus Ryan,Anne Rogers,Helen Lester |
| Subject Matter | Health & social care,Mental health |
GPs’ and patients’ views on recovery
from psychosis
Seamus Ryan, Anne Rogers and Helen Lester
Dr Seamus Ryan is a Trainee
Clinical Psychologist, based at
School of Psychology, National
University of Ireland, Galway,
Ireland.
Anne Rogers is a Professor of
Health Systems
Implementation, based at
Faculty of Health Sciences,
University of Southampton,
Southampton, UK.
Helen Lester is a Professor of
Primary Care, based at School
of Health and Population
Sciences, University of
Birmingham, Birmingham, UK.
Abstract
Purpose – Recovery is a key organising principle underlying mental health services, but remains
under-researched in primary care. The purpose of this paper is to explore what recovery from psychosis
means from multiple perspectives, the role of primary care in fostering recovery, and interventions that might
enhance its promotion in primary care.
Design/methodology/approach – A total of 20 patients who had experienced psychosis and 24 General
Practitioners (GPs) with varying expressed interest in mental health participated in semi-structured
interviews, and were invited to two subsequent mixed focus groups. Data were analysed using Framework
Analysis.
Findings – Recovery was conceptualised by GPs without a specialist clinical interest in mental health
as improvements in symptomatic outcomes, by GPs with a special interest as improvements in social
or functional outcomes, and by patients as a process involving a “whole person”approach. Both GPs
and patients highlighted benefits of primary care including continuity, accessibility,and the role primary care
professionals can play in supporting patients’ families, and helping patients expand social support
networks. Despite feeling “fobbed off”at times, patients desired a shift in responsibility for psychosis from
secondary to primary care.
Practical implications – Reflective peer supervision meetings for GPs and patient-led training might
improve primary care’s ability to provide a more recovery-focused environment.
Originality/value – This study provided original and valuable findings regarding how GPs viewed their own
role in promoting recovery from psychosis. This study also provided original findings regarding how patients
viewed the role of primary care in promoting recovery from psychosis.
Keywords Mental health, Recovery, Schizophrenia, Primary health care, Psychosis, General practice
Paper type Research paper
Introduction
Psychosis is relatively common and costly at an individual and societal level. The lifetime
prevalence of schizophrenia is up to 1.4 per cent (Cannon and Jones, 1996) and for bipolar
I disorder is 0.24 per cent (Pera
¨la
¨et al., 2007).
People with schizophrenia or bipolar disorder have a significantly reduced life expectancy
compared to the general population (Wahlbeck et al., 2011) with two-thirds of the mortality gap
explained by physical disorders. Social withdrawal, exclusion, and restricted opportunities
emerge quickly from the onset of symptoms leading to disengagement from education and
unemployment. Fear of stigma and discrimination can also lead to loss of social confidence
(World Health Organisation, 2011). Totalservice costs for people withschizophrenia and bipolar
disorder in England are estimated at £3.8 billion (h4.9 billion), rising to £6.3 billion (h8.1 billion)
over the next 15 years (McCrone et al., 2008).
Given this background of exclusionand inequity, the concept of recovery hasparticular salience.
It has become the key organising principle underlying mental health services in New Zealand
(Mental Health Commission, 1998), the USA (Department of Healthand Human Services, 2003)
The authors would like to thank all
GPs and patients who participated
in this study,and the peerreviewers
from previous journal submissions
who provided recommendations
for the reporting of this research.
DOI 10.1108/MHRJ-11-2013-0035 VOL. 19 NO. 2 2014, pp. 99-109, CEmerald Group Publishing Limited, ISSN 1361-9322
j
MENTAL HEALTH REVIEW JOURNAL
j
PAGE 99
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