GPs' experiences of children with anxiety disorders in primary care: a qualitative study

Br J Gen Pract. 2017 Dec;67(665):e888-e898. doi: 10.3399/bjgp17X693473. Epub 2017 Oct 23.

Abstract

Background: Anxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs' perspectives on and experiences of supporting children with these disorders.

Aim: To explore the experiences of GPs in relation to identification, management, and access to specialist services for children (<12 years) with anxiety disorders.

Design and setting: Twenty semi-structured interviews were conducted with GPs in primary care throughout England.

Method: GPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis.

Results: Data from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services).

Conclusion: GPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children's mental health, as well as potential for greater collaboration between primary and specialist services.

Keywords: anxiety disorders; barriers; child mental disorders; general practice; health services accessibility; primary health care.

MeSH terms

  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy
  • Attitude of Health Personnel
  • Child
  • England
  • Female
  • General Practitioners / psychology*
  • Health Services Accessibility / standards
  • Humans
  • Male
  • Physician-Patient Relations
  • Practice Patterns, Physicians' / standards*
  • Primary Health Care*
  • Qualitative Research
  • Referral and Consultation / standards*