GPs are in a good position to identify patients who are at risk of developing psychosis. However, it is not always easy for them to do so. In a recent study of the possible barriers, researchers at the University of Bristol’s Centre for Academic Primary Care and Centre for Academic Mental Health found that not all GPs were familiar with the concept of being ‘at risk of developing psychosis’ and some felt they would benefit from further training in identifying patients who might fall into this group.

The research, funded by the NIHR Bristol Biomedical Research Centre and published in the British Journal of General Practice, explored GPs’ views and experiences of identifying patients with an ‘at-risk’ mental state. Twenty GPs from the South West of England were interviewed between March and July 2019.

Other barriers to managing patients with an at-risk mental state included patients not presenting or disclosing psychotic symptoms, lack of continuity of care (i.e. being seen by the same GP), and only the most severely ill patients being able to access specialist mental health services.

Daniela Strelchuk, lead author of the study, said:

“About a third of people who experience early symptoms of psychosis, such as hearing voices or holding paranoid beliefs, will go on to develop psychotic illness over a three-year period. GPs play a key role in referring these patients to secondary care services but the results of our study show that not all GPs were familiar with this patient group. GP training on the early symptoms of psychosis and the use of short screening tools might help improve identification. This is important because early intervention can reduce rates of transition to psychosis by approximately 50 per cent.”

Professor Katrina Turner, from the Centre for Academic Primary Care who supervised the study, said:

“Identifying people at risk of psychosis in primary care is difficult, and GPs may lack the time and confidence to do this. Provision of GP training might help, along with greater support for continuity of care and improved access to specialist services.”

 

Read the paper

‘Identifying patients at risk of psychosis: a qualitative study of GP views in South West England’ by Daniela Strelchuk et al. Published in British Journal of General Practice (BJGP). November 2020.

Listen to the podcast

Listen to the BJGP podcast about the study with authors Daniela Strelchuk and Professor Stanley Zammit.