Capturing the Unsaid: Nurses’ Experiences of Identifying Mental Ill-Health in Older Men in Primary Care—A Qualitative Study of Narratives

Abstract

This study describes nurses’ experiences in identifying mental ill-health in older men in primary care. The aging population is growing in Sweden and life expectancy is increasing. Age is a risk factor for mental ill-health. Older men are over-represented in deaths from suicide. When older men seek primary care, it is often because of somatic symptoms and rarely for mental health issues. A questionnaire with five open questions was answered by 39 nurses from 10 primary care centres and subjected to inductive qualitative content analysis. The results revealed a main theme—capturing the unsaid—and two categories: (1) feeling secure in the role, with three subcategories (building trust, daring to ask and interpreting signs); and (2) the need for resources, with two subcategories (time and continuity, and finding support in collaboration). The results confirm that nurses in primary care play a key role in identifying mental ill-health in older men. There is a need for resources in the form of time, competence and collaboration with other professionals and patients’ relatives. This strategy will establish best practice and provide evidence-based care to facilitate improvements in older men’s mental health and prevent suicide.

Health Service Protection vis-à-vis the Detection of Psychosocial Risks of Suicide during the Years 2019–2021

“…Providing that, it should be noted that the evaluation of the suicidal patient must continue to be the responsibility of an expert mental health professional who has to combine clinical judgment with knowledge of empirically validated risk and protective factors and weigh these factors in the best way possible [16]. However, as has been shown in the present research and in previous studies [47,49], this expert's work is not necessarily limited to specialized mental health services, since the role of primary care is essential in the screening and follow-up of patients. Thus, a greater attention to specialized training for the detection of suicide would be another key factor in effective prevention, including all professionals in contact with the population at risk.…”

Coping strategies for increased wellbeing and mental health among older adults during the COVID-19 pandemic – a Swedish qualitative study

“…However, as discussed earlier, SES and coping skills are influenced by a complex interplay of factors, necessitating caution in drawing conclusions regarding the role of SES in individuals' coping abilities. Lastly, it is important to note that mental health issues, particularly among men in this age group, may be considered taboo or unaccustomed to open discussion (Karlsson et al, 2021). To address this and obtain a broader range of participant perspectives, we purposefully recruited six individuals who expressed high levels of concern and worry.…”