Patients’ experience of being triaged directly to a psychologist in primary care: a qualitative study

Abstract

BackgroundIn a primary health-care centre (PHCC) situated in a segregated area with low socio-economic status, ‘primary care triage’ has increased efficiency and accessibility. In the primary-care triage, the nurse sorts the patient to the appropriate PHCC profession according to described symptoms.AimThe aim of this study was to examine the patients’ experience of being triaged directly to a psychologist for assessment.MethodInterviews were conducted with 20 patients and then analysed using qualitative content analysis.FindingsThe results show that patients contacting the PHCC for mental health issues often are active agents with their own intent to see a psychologist, not a doctor, as a first-hand choice when contacting the PHCC. Seeking help for mental health issues is described as a sensitive issue that demands building up strength before contacting. The quick access to the preferred health-care professional is appreciated. The nurse was perceived as a caring facilitator rather than a decision maker. It is the patient's wish rather than the symptoms that directs the sorting. The patients’ expectations when meeting the psychologist were wide and diverse. The structured assessment sometimes collided and sometimes united with these expectations, yielding different outcome satisfaction. The results could be seen in line with the present goal to increase patients’ choice in the health-care system. The improved accessibility to the psychologist seems to meet community expectations. The results also indicate a need for providing more prior information about the assessment and potential outcomes.

Mental health triage tools: A narrative review

“…When MHT tools are applied in primary care, patients report increased satisfaction due to perceived improved accessibility to care and greater determination over treatment (Dahlöf et al . 2014).…”

“…In nonemergency settings, such as community clinics, the application of MHT tools may be associated with reduced wait times and improved outcomes (depression scores; Smith & Hadorn 2002, Tulloch et al 2018. When MHT tools are applied in primary care, patients report increased satisfaction due to perceived improved accessibility to care and greater determination over treatment (Dahl€ of et al 2014).…”

Effective teamwork in primary healthcare through a structured patient-sorting system - a qualitative study on staff members’ conceptions

“…A special sorting manual was developed for this purpose in order to standardize the procedure and physiotherapists, psychologists and occupational therapists started to treat patients with certain conditions triaged directly to them by the nurses without a referral from a general practitioner [ 15 ]. Follow-up studies showed that the structured patient-sorting system seemed to satisfy the patient’s wish and need for quick access to a psychologist and that long-term healthcare consumption decreased for patients initially seeing physiotherapists [ 18 , 19 ]. The structured patient-sorting system has been adopted by a number of primary care centres in Sweden.…”

Service user experiences of mental health assessments: a systematic review and thematic synthesis of qualitative literature

“…Assessors that demonstrated warmth, respect and non-judgemental attitudes and a flexible approach tailored to individual needs were experienced positively (Boscarato et al, 2014;Dahlöf et al, 2014;Hamilton et al, 2011;Meehan et al, 2012). Additionally, assessments that were person-centred, dynamic and receptive to modification as service users provided further information or as their needs changed were experienced more positively allowing individuals to feel more relaxed, comfortable, involved and empowered (Danna, 2011;McDonagh, 1997).…”