6.5 PRIMARY CARE

PROMOTING MENTAL HEALTH

Key Messages

While 84% of residents are comfortable speaking to their primary care provider about mental health, only 53% of residents agree that their primary care provider asks them about their mental health.

Family doctors are the top-of-mind resource for mental health reported by Lambton residents.

Greater partnership and coordination between mental health services and primary care providers may be an important area of focus for mental health system improvement.

We need a better understanding of primary care system effectiveness with respect to mental health prevention, diagnosis and treatment.

We need a better understanding of training and education needs to support effective mental health service delivery in primary care.

“I would be most comfortable speaking with an experienced health care provider or professional. One who is compassionate, has demonstrated patience and experienced with PTSD. I would choose this individual, as the person is an outsider, has no clear bias, and is experienced with the emotions I may be experiencing.”

– Community member

Primary Care Providers

The majority of Lambton residents report that they would first turn to their primary care provider for supports or services related to mental health. Residents are generally open to speaking about their mental health issues with their primary care provider. Those who are flourishing are more likely to say they are comfortable than those who are moderate or languishing. This may reflect a difference between those who have tried to discuss mental health with a primary care provider and those who have not. Women are slightly more likely than men to report feeling comfortable in speaking with their doctor. There are no significant differences by age.

Primary care providers are more likely to ask about mental health and provide resources to those who are younger and living in lower income households. Of those who had ever been diagnosed with a mental illness, only 68% reported that their primary care provider asks about their mental health and wellbeing.

Would first turn to their primary care provider for supports or services related to mental health
0
Comfortable speaking to their primary care provider about mental health

(84% total vs. 87% flourishing;
76% moderate; 62% languishing)

60
VERY COMFORTABLE
24
SOMEWHAT COMFORTABLE
Report that their doctor asks about their mental health and well-being
0
61
OF THOSE 18-34 YEARS
60
OF THOSE <$65,000
68
OF THOSE WITH A DIAGNOSED MENTAL ILLNESS
Have talked to their doctor about their mental health in the past year
0

(21% flourishing; 46% moderate, 73% languishing)

Report their primary care provider gives them information and resources to help take care of their mental health and well-being
0

(70% of those <$30,000 vs. 51% of those $100K+)

While comfort levels with speaking to others about mental health issues varied, some individuals prefer speaking to a professional. Professionals were trusted for their expert advice and were seen to offer a confidential and non-judgemental environment.

“If I talked to anyone I would talk to my family doctor, because my family doctor is a medical professional.”

– Community member

However, some individuals preferred speaking to family and friends about their mental health due to negative experiences with professionals.

“I feel less comfortable talking to a healthcare professional than my friends and family as my experiences with them in the past have not been helpful to me.”

– Community member

“I feel completely embarrassed talking with any of my health professionals. I’m always leaving an office feeling embarrassed, more depressed and anxious. I feel like my concerns are not being taken seriously and are being overlooked because of my label “health anxiety aka hypochondria”.

– Community member

“I’ve had doctors laugh and go over why they feel nothing is wrong with me and tell me that what I’m feeling isn’t happening when indeed it is and I can see it and feel it physically. So can my husband but it’s downplayed because of the stigma. I feel like a laughing stock.”

– Community member

There was a particular emphasis on not dismissing or “making light” of concerns and having the appropriate knowledge to talk about mental health and refer to additional resources.

“They shouldn’t ever say “It’s not that bad.”  It’s very scary when our minds are thinking things that are terrifying to us, or our bodies keep doing weird things uncontrollably.  It is that bad to us.”

– Community member

“People are judged and treated differently, if you have a heart attack and seek professional help then you are intelligent cause you’ll die if you don’t. But if someone with mental illness seeks professional help then they are made to prove they have a problem. The judgment sits at the doors of the professional first.”

– Community member

“I understand that family doctors aren’t specialized in all areas.  However maybe make it mandatory for physicians to take seminars to educate them on mental illness and proper etiquette when conversing and referring other services.   Physicians should refrain from telling you that you’re ok when they don’t have tests to back up their idea.”

– Community member

“To break this stigma? The doctors especially whether in ER departments or GP, should have increased or extensive mental health training. As well as other health care professionals – for instance, nurses.”

– Community member

Further research among primary care providers can allow for a better understanding of how they are addressing mental health needs with patients and to identify gaps and opportunities for the provision of mental health resources in primary care.

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CONCLUSION