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Primary mental healthcare: care professionals’ perspectives139aware that this limited the patient’s choices. They found it difficult to assess the extent to which the patient could take responsibility in this regard and to determine their role as practitioner in this process.It’s also a difficult balancing act. I find it complicated, how much control do you give to the other person, when sometimes you just want to say, ‘we’re going to do this and this and this now because I see it’s necessary’, but at the same time, you don’t want to completely override someone. (F4, GP)Box 6.3. Theme 2: Importance and difficulties of establishing a good doctor–patient relationship. Practice-based insights that participants in our study deemed to contribute positively to the quality of primary mental health (MH) care for adults with mild intellectual difficulties (MID)aInvest in the doctor–patient relationshipy The practitioner adapts to the patient’s communication level: using simple words, speaking at a slower pace, and providing frequent repetition y The practitioner gives sufficient attention and time to the patient; for example, conducting longer consultations or engaging regularly in supportive consultationsy The practitioner provides a calm and structured environment during consultationsy A designated practitioner in the practice is assigned as the main point of contact and responsible for continuity of carey The practitioner notes the MID and additional communication needs in the medical record so that everyone in the practice can take this into account when interacting with the patienta For readability, the term practitioner is used for both GPs and MHNPs; when relevant, GP or MHNP is specifiedTheme 3: Facilitating and hampering roles of the patient’s networkSome patients with MID have a formal and/or informal network that can provide support to both the practitioner and the patient. A supportive network provides the practitioner with valuable knowledge about the patient and contributes to stability in their lives in both the short and the long term. However, in the participants’ experience, networks can also be part of, or contribute to, patients’ problems, by amplifying patients’ stress, underestimating or overestimating their symptoms, lacking sufficient knowledge or skills to provide appropriate support, or having unrealistic or unspoken expectations of the practitioner.6Katrien Pouls sHL.indd 139 24-06-2024 16:26