What factors organise a GP’s aptitude to elicit the disclosure of psychological distress in men and how do they utilise this information?

Objective: Existing research suggests that men are less likely to be diagnosed with common mental illnesses, but are more likely to drink to hazardous levels and attempt and complete suicide, suggesting that mental illness is prevalent among men, but how they express their distress can be externalised. The need to attend to men’s help-seeking behaviour has been recognised and is extensively researched; but, the role of the medical system in supporting this access is less researched. However, the role of General Practitioners (GPs) in supporting men’s access is recognised. This study explored how GPs encourage their patients to disclose symptoms of psychological distress, and how they make decisions regarding treatment. The results with a specific focus on men were highlighted. Design: A qualitative inductive Thematic Analysis was undertaken to identify themes emerging from the data. Method: Nine GPs (mean age = 35) were recruited. Data was collected using semi-structured interviews about their consultations with patients presenting with psychological distress. Results: Three themes emerged; 1) “Facilitating Techniques” which captured factors assisting consultations, encompassing five subthemes; Interpersonal Skills, Masking and Unmasking, Specific methods used to Gather Information, Mental Health Awareness and Organisational Influences; 2) “Recognition of the Patient’s Treatment Preferences”, which captured how GPs are guided by their patient’s preferences, men’s preference of medication, and the immediate availability of medication; and 3) “Cultural Prism”, which captured cultural factors through which help-seeking is governed from the GPs’ perspectives. Conclusions: This research has improved the understanding of how GPs elicit men’s disclosure of psychological distress, and their decision-making processes about treatment. It also highlights the benefits of inviting men to attend regular health checks, which has important implications in reducing some of the barriers of help-seeking in men. However, the clinical implications and conclusions are drawn tentatively given the perceived limitations of the study