Page 133 - Demo

Primary mental healthcare: care professionals’ perspectives1316IntroductionIn many countries, the general practitioner (GP) is the first point of contact for people with mental health (MH) problems, and the gatekeeper to MH services. However, GPs do not always feel equipped to provide mental health (MH) care to people with mild intellectual disabilities (MID), 1, 2 defined as a significant deficit in intellectual (IQ range 50–85) and adaptive functioning.3 This is worrying, as insufficient primary MH care in this group may lead to more severe or chronic MH problems. 4People with both MID and MH problems put a high demand on primary care practices. 5 The prevalence of MH problems in people with MID is twice that of the general population estimate. 6 Furthermore, this patient group consults their GP more frequently compared with patients without intellectual disabilities (ID) or with MID alone. 5Previous research indicates that current primary MH care for people with MID requires improvement. 2 GPs internationally lack evidence-based knowledge and MH screening tools for people with MID, 1, 7 struggle to identify and register the MID, and therefore have difficulty taking the MID into account when establishing the correct MH diagnosis and treatment.2 This may lead to underdiagnosis, overmedication, and the progression of MH problems. 2, 7In order to improve primary MH care, it is important to stay close to the actual experiences of patients to whom this care is provided and of care providers who provide the care. In the Netherlands, this is the GP, often supported by a mental health nurse practitioner (MHNP). An MHNP works under GP supervision, has a role in assessing MH symptoms, and gives short periods of treatment and support to people with mild MH problems. Results of an interview study revealed that people with both MID and MH problems have various additional needs and expectations regarding their GP, family, and professional carers, but their need for self-determination remains important. This stems from a sense of vulnerability when visiting their GP, which is related to their MID and reinforced by MH problems. 8Katrien Pouls sHL.indd 131 24-06-2024 16:26