Over the past few weeks, the Doc Ready team has been carrying out a wide range of research in the build-up to running a co-design workshop to develop the idea further. This session will be run in Brighton on Saturday 20th April, so if you’re a young person or mental health professional and would like to get involved by joining us please register here.
Doc Ready is a product that will facilitate positive and useful conversations between a young person and their GP during mental health consultations. We already have a good understanding of the need from the young person’s perspective, but it’s also essential that we understand what’s important for the doctor, to have the most efficient and helpful consultation possible. We’ve been conducting interviews and using questionnaires to ask GPs about their ‘best practice’ guidelines for mental health consultations; what questions they need to ask and why they ask them; what happens at the end of an appointment and what problems they often encounter before, during and at the end of their time with a young person. We’ve also been asking about their feelings about the Doc Ready product in general.
Here are some of our key findings to date:
1. There was a unanimous response to the information which is essential to gain during a consultation.
- Mental symptoms – thoughts, hallucinations etc.
- Physical symptoms – appetite, sleep etc.
- Emotional state – moods, manias etc.
- Duration of episode (how long have you been feeling like this?)
- Psycho-social context of the patients life (events which might have triggered episode)
- Lifestyle factors – alcohol, drugs, stress etc.
- Risk presented to safety – self-harming, suicidal, any other parties at risk.
- Medical history – physical, mental, emotional. Is there a family history of mental illness?
- Impact on ability to function/ day-to-day life
2. There was less concern from GPs about…
- The young person’s feelings about what they wanted to happen next
- How the young person engaged and responded throughout the appointment
- Did the young person feel they would benefit from working with a therapist or counsellor?
We feel that it’s part of Doc Ready’s job to place emphasis on the importance of these issues, to help young people to have a voice and feel empowered.
3. Embarrassment and lack of information were common problems doctors found young people faced before coming to their first consultation:
They spoke about “the fear of the unknown”. Self-diagnosis using the internet or the advice of peers was also a big concern. Our content must serve the users’ need to reassure and inform and avoid putting labels to experiences.
4. Some questions the doctors ask can be confusing or illicit unhelpful responses:
“Perception of what it is to be depressed, compared to the doctors’ definition is often quite different” said one GP. Another said, “[young people] often lack the confidence and vocabulary to describe accurately what is happening to them”
5. Most GPs were very receptive to idea of a checklist:
Three-quarters responded very positively to the idea of a young person bringing a list of their concerns to their appointment with them. Some, however, had concerns that the list shouldn’t be too long or complex as it could distract from the natural conversation during the consultation and take a long time. Another concern that was raised was that some GPs might be a “bit put-out” by a young person “trying to tell them how to do their job”.
6. Things doctors thought should be recorded after the initial consultation (in order of priority):
Follow-up appointment details; prescription details; emergency numbers; info about therapy; lifestyle advice resources; self-help advice resources.
7. Preferred methods of recording this information:
Hand-written notes; printed literature; mobile phone app all had equal highest votes, but none were unanimous. This is going to be one of the most important decisions we make in the design of Doc Ready, so we really need to consider how we can provide the best user experience possible while keeping the product simple and relevant.
All of these insights, as well as our work with young people, will prove to be invaluable to the design process of the Doc Ready toolkit. Our research is ongoing, and we’re planning to speak to more mental health professionals and GPs over the next few weeks.
Are you a GP or work in mental health and would like to help by contributing to our research? If so, we’d love to hear your thoughts and you can share these by filling out our questionnaire here. Thank you!
We’ll be keeping you posted on more Doc Ready developments in the coming weeks, so watch this space…