Discussing poverty within primary-care consultations: implications for mental health support

Abstract

Background Poverty can have significant impacts on health and wellbeing. However, asking patients about their broader socio-economic circumstances is not routine within primary care consultations.

Aim To understand healthcare professionals’ experiences of communicating with patients about their socio-economic circumstances and how a bespoke training programme supported these conversations in routine consultations.

Design & setting Healthcare professionals from 30 GP practices across England received training to improve understanding and communication with patients about the ways that poverty impacted their mental health.

Method Semi-structured interviews were undertaken with 49 GPs and allied health professionals to understand barriers and enablers to communication around poverty and the impact of the training on their consultation practice.

Results Health professionals often lacked confidence in discussing socio-economic issues and welcomed information on how to do this sensitively. Asking questions relating to poverty-related stresses was felt to lead to better understanding around the causes of mental distress, avoidance of problematic assumptions and inappropriate antidepressant prescribing and to enable more coordinated and appropriate support from practice teams.

Conclusion Asking patients about their socio-economic circumstances can facilitate provision of appropriate support.