Perceived benefits and challenges one year after receiving brief therapy in a district psychiatric centre. An exploration of patients' and GPs' experiences: A qualitative study.

Abstract

Background: Scarce treatment resources put pressure on mental health services prompting innovations in service provision. Various innovative strategies have been introduced to provide patients with improved and effective treatment due to increased demands for mental health services. In 2016 a district psychiatric centre (DPC) started a brief treatment program to provide early and effective help for moderate depression and anxiety. There is little evidence regarding the potential benefits that different mental health patients may experience after receiving brief therapy treatment. Moreover, few studies have explored the experiences of referring general practitioners (GPs) with different patient outcomes after brief therapy. The aim of this study was to investigate the long-term experiences of patients who received brief therapy at a DPC at least one year ago, as well as the experiences of general practitioners (GPs) who referred patients for such treatment since 2016. Specifically, the study sought to determine patterns in the patients' stories and GPs' experiences to see if it could provide new insight for further studies.

Methods: We conducted individual interviews with a total of seventeen participants, consisting of eleven patients and six GPs. Using an exploratory approach, we analyzed patients' narratives as they described them in the interviews, employing inductive and thematic analysis techniques. The GPs' experiences of referring several patients to brief therapy were also subjected to thematic analysis. In addition, we synthesized the patients' experiences into condensed stories for comparison. The experiences of GPs, who had referred patients to this brief treatment program over several years, were compared with the patients' experiences and reflections one year after receiving brief therapy. This comparison aimed to challenge and deepen the understanding of condensed patient stories.

Results: The main results are presented as three condensed patient stories: A) Coping with mental problems; B) A path to another treatment; and C) Confusion and lost hope. The GPs' experiences are included in each condensed patient story to challenge and elaborate on relevant aspects.

Conclusion: Time-limited brief therapy was experienced as beneficial for patients with moderate affective and anxiety disorders but was experienced as unsuitable for those with more severe conditions. This raises important questions about the appropriateness of offering brief therapy to a diverse patient population and the efficient use of healthcare resources. We recommend further research to enhance understanding and develop tailored treatment services for different ailments. Identifying which patients benefit most from specific therapies can improve outcomes and resource allocation. An important improvement measure might be to enhance early communication between patients, General Practitioners (GPs), and District Psychiatric Centres (DPCs) before referrals. Ensuring brief therapy is targeted to those likely to benefit the most will enhance treatment effectiveness. Additionally, we suggest implementing joint assessment meetings to facilitate comprehensive information exchange and coordination among different care levels. This approach would improve assessments, treatment planning, and follow-up strategies, ultimately leading to better patient care and resource management.