title: Information giving challenges and support strategies at the time of a mental health diagnosis: qualitative views from Australian health professionals.
abstract: Communication of a mental health diagnosis can be a difficult process and is a poorly understood area of service provision. The aim of this qualitative study was to examine clinicians' perceptions of barriers and helpful strategies to discussing information about a mental health condition.
  
  
  
  Qualitative interviews with 19 Australian clinicians (general practitioners, mental health nurses, psychiatrists, and psychologists) working in several settings (community, hospital inpatient, outpatient, accident and emergency) and locations (urban, suburban and rural) were conducted and analysed thematically.
  
  
  
  After theme saturation was reached, four primary themes relating to barriers and facilitators to communication at the time of diagnosis were identified in the data. Outside a recognised lack of focus on this area in training, themes included (1) engagement and timing of conversations; (2) stigma and its reduction; (3) perceived and desired knowledge for diagnostic information; and (4) working with distress. The synthesis of themes is demonstrated in a flowchart of suggestions for communicating news of mental health diagnosis that tracks the patient journey in receiving information from initial engagement to follow-up.
  
  
  
  Talking with an individual about a mental health diagnosis is a non-linear, complex and changeable situation. However, health professionals report using specific strategies to aid this communication process, to meet the specific individual's needs. Strategies such as tailoring to the person's situation, utilising collaborative practice, effective coordination, and addressing stigma may be useful to inform clinician training and support whilst diagnosis remains a key feature of the mental health system in Australia.
authors.affiliation: School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia. alyssa.milton@sydney.edu.au.
authors.forename: Alyssa C
authors.initials: AC
authors.lastname: Milton
authors.affiliation: Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mullan
authors.affiliation: School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: Hunt
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D003142:Communication; D005260:Female; D006801:Humans; D007318:Inservice Training; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008605:Mental Health Services; D008875:Middle Aged; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D036301:Qualitative Research
keywords: Communication; Health service delivery; Mental health and illness; Patient–provider relationships; Qualitative research; Stigma