The growing number of people presenting with mental health problems to general practice is a worrying trend, however, the involvement of GPs in mental health research is an area for hope. Being a practising GP and an active researcher are not as incompatible as one may think — a growing number of GPs are conducting research, and in so doing, they will be influencing clinical practice and guiding health policy.
WHY SHOULD GPs DO RESEARCH?
Of course, we want to be in a position to prevent rather than treat, and to promote wellbeing. But the difference between these ideals and the reality is sometimes overwhelming. For GPs it’s vital that experience and knowledge of practice, contexts, and the situations we work in can be shared and discussed. To do this effectively we have to be completely embedded in our present reality — as we are — but also able to step back and think about how it could be different and better. Taking part in research can give us this opportunity, and there are some great resources out there supporting those of us who are taking this path.
SO, WHERE TO START?
It’s important to connect with other health professionals who are conducting clinical research. Today, researchers are not only based in universities. There are health professionals of all types working in a range of institutions such as NHS services, universities, charities, and elsewhere. It’s a good idea to make links with the department of primary care in your local university but there’s no reason not to look further afield online for advice and support. Resources like the National Institute for Health Research (NIHR) Incubator for Mental Health Research1 can help GPs exploring research opportunities. The Mental Health Research map2 is one useful way that you can connect with other health professionals interested in mental health research and find someone who can help, or guide you in the right direction. The site also offers advice, information about funding sources and networks, and useful career stories about how others combine their clinical and research work. It’s helpful to understand how and why others are doing it. There are also opportunities to support research through becoming a Royal College of General Practitioners research-ready practice and forming links with your local NIHR clinical research network to facilitate recruitment of your patients to mental health studies.
WHAT ARE SOME OF THE BIG QUESTIONS?
While our treatments for depression and anxiety work for many people, they are also only partly effective or ineffective for others.3 We need new approaches for people who have not responded to treatment with standard antidepressants or psychotherapies. GPs have a lot to contribute to understanding the reasons for non-response and finding new ways of helping patients. Another area of importance to GPs and patients is self-harm. There is currently very little that GPs can offer young people who self-harm, and we know self-harm is a key risk factor for suicide.4
Mental health services and access vary widely across the country. What’s effective? What’s the best value? Rigorous evaluations of new interventions in the NHS, voluntary sector, and local communities are needed to improve understanding of how to support and look after patients with mental health concerns. GPs with on the ground experience of working in a variety of settings are needed to contribute and inform the future evidence base. GPs understand better than most how mental and physical health are intimately connected. Major shifts in understanding happen thanks to research, which incrementally builds up the evidence base for positive change on how to treat people and promote good mental health. Not many GPs are conducting mental health research at the moment, but those that do see a real opportunity to make a difference through early detection, intervention, and prevention, thereby reducing the chances of long-term mental illness. We know mental health problems develop early, 50% by the age of 14,5 so early detection and intervention can help to prevent mental illness into adulthood and support wellbeing. A growing concern is the mental health and wellbeing of general practice teams and the impact of workload on the wellbeing of GPs — a crucial research focus for the future. Through active involvement and engagement of GPs in primary care mental health research, we have a real opportunity to foster change and improve the care for our patients, and for our colleagues alike.
- © British Journal of General Practice 2021
REFERENCES
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