Managing patients with mental health conditions in family medicine

General practitioners (GPs) often encounter patients with mental health disorders, with prevalence rates in primary care ranging from 25% to 60%, including in Switzerland. GPs frequently serve as the first or only point of contact for these patients, playing a crucial role in detection, prevention, and management. Despite this, many GPs feel underprepared to address mental health issues, often citing limited time, heavy workloads, and insufficient training as barriers. The main objective of this study was to explore in depth potential difficulties encountered by GPs in the management and follow-up of patients with mental health problems. 

We chose a qualitative approach with semi-structured individual interviews with 17 GPs from French-speaking Switzerland. Interviews were transcribed and analyzed through reflexive thematic analysis, with an inductive theoretical framework. Once the most important themes and sub-themes emerged, we proceeded to external and internal validation. Triangulation between researchers was carried out throughout the whole process.

Four principal themes emerged. GPs reported that: i) they enjoy caring for patients with mental health challenges, as they see it as a core part of holistic care and value their unique position in providing long-term, comprehensive support; ii) they face significant systemic barriers, including frustration with insurance-related limitations; iii) they lack of collaboration with psychiatrists and they face insufficient resources; and iv) they called for help and new ideas to improve their care.

Swiss GPs serve as critical providers of mental health care. Their professional experience reveals a dual reality; dedication to patient care alongside frustration with systemic constraints. This tension highlights the complexity of mental health management in primary care. Sustainable improvement requires addressing gaps in provider training, inter-professional collaboration, and public health initiatives to mainstream mental health into society.