Barriers to the identification, management and referral of childhood anxiety disorders in primary care

Anxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, General Practitioners (GPs) are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs’ perspectives of supporting children with these disorders. The aim of this thesis was to explore the barriers faced by GPs in the England to effectively identifying, managing and accessing specialist services for childhood anxiety disorders. This was achieved using a mixed-methods approach, encompassing a systematic review of the literature, a qualitative study of 20 GPs and quantitative survey of 971 GPs in England. When viewing this thesis as a whole, it is clear that GPs feel ill-equipped to identify, manage and refer anxiety disorders in this age group. Poor training and a lack of support appears to be affecting their confidence in identification and management, in addition to the issues with long waiting times and a lack of access to specialist services for their patients. Factors such as being female and being a parent to a child over five increase their confidence in identification and management, respectively. These findings highlight the need to strengthen GP training and facilitate access to resources and services to enable them to support children with these common but debilitating conditions