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Primary mental healthcare: a scoping review33274, 81, 85, 86 It is stipulated that this relates to GPs’ lack of specific experience and knowledge, 51, 81, 87 uncertainty about who of the involved professionals is responsible for follow-up, 47, 83, 86, 88, 89 patient problems in communicating and presenting (side) effects of medication, 44, 49, 65 and dependence on observations by, and cooperation with, caregivers. 39, 44, 49, 50, 62, 69, 72Knowledge and experience There is general consensus that GPs generally have limited knowledge about, and experience in, managing patients with ID and MHD, 24, 37, 40, 42, 43, 46, 50-52, 58, 66, 69, 81, 87, 90-96 caused by a lack of priority in medical training programmes 37, 40, 43, 50, 52, 58, 66, 93 and a lack of research concerning this patient group. 93 This results in limited evidence-based knowledge 43, 47, 50, 65, 67, 93, 97and reliance on experience-based knowledge instead.50 It is indicated that limited knowledge and experience create feelings of insecurity in the GP when addressing patients with ID and MHD, 50 lack of caregivers’ confidence in the GP, 52 and insufficient care. 37, 41, 44, 52, 58, 66, 81, 91, 92, 97 Although GPs are interested in more training and education about patients with ID and MHD,24, 37, 41, 42, 44, 52, 58, 66, 87, 90, 91 in practice it is seen as a challenge to engage them, caused by the small size of the population and the variety of competing medical issues. 58, 70 Publications underline the importance of investment in more research and initiatives for effective training, skill development, 37, 42, 50, 58, 92, 96 and evidence-based guidelines for GPs. 42, 50, 98Caregiver rolesIn the publications, it is noted that patients with ID and MHDs are often reliant on formal or informal caregivers for receiving care, 23, 43, 49, 57, 62, 69, 72, 99in the first place, to recognise symptoms of MHDs and seek help. 23, 43, 62, 73, 99For this task, it is deemed important that caregivers have some knowledge of associated symptoms; however, this knowledge is often lacking. 23, 42-44, 100Secondly, patients are frequently dependent on caregivers for joint decision making 44 and giving informed consent regarding treatment options like psychotropic medication. 4, 49, 65, 68, 72 Thirdly, caregivers have important roles in the execution of the treatment plan regarding medication adherence and identifying and monitoring possible side effects. 49, 50, 73, 82 A symptoms checklist is mentioned as a helpful tool for caregivers to provide the GP with the information needed. 40, 73 Furthermore, it is noted that the referral process can be complex, and support by caregivers can be essential to prevent delay in care. 96, 100Katrien Pouls sHL.indd 33 24-06-2024 16:26