Meeting the mental health needs of people with multiple sclerosis: a qualitative study of patients and professionals.
To explore perspectives and experiences of people with multiple sclerosis (MS) and health care professionals of mental health support for MS in the UK.



24 people with MS, 13 practice nurses, 12 general practitioners (GPs) and 9 MS specialist nurses were recruited through community groups and primary care practices across North West England. Semi-structured interviews were conducted, and data analyzed thematically using constant comparative analysis within and across the data sets. The theoretical framework of candidacy was used to interrogate data.



Four themes were identified: candidates for care, management choices, defining roles, and permeability and responsiveness.



Candidacy for care, and symptom management, depended on the framing of symptoms through a social or medical model of depression. Normalizing symptoms could prevent help-seeking by patients. Reported referral behavior varied by professional group, based on perceived remit, competency and training needs. GPs were perceived by patients and other professionals as central for management of mental health needs in MS, but may not perceive this role themselves, suggesting a need for increased knowledge, training, and improved access to specialist care. Implications for Rehabilitation Anxiety and depression are common in people with MS. Management of mental health needs in people with MS relies on complex decisions made by both people with MS and health care professionals. General practitioners may play a key role in the ongoing management of mental health needs of people with MS.
a Section for Clinical and Health Psychology, School of Psychological Sciences , University of Manchester , Manchester , UK.|b Manchester Mental Health and Social Care Trust, NHS , Manchester , UK.
Abigail
A
Methley
c NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre , Institute of Population Health, University of Manchester , Manchester , UK.
Stephen
S
Campbell
c NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre , Institute of Population Health, University of Manchester , Manchester , UK.
Sudeh
S
Cheraghi-Sohi
d Primary Care and Health Sciences , Keele University , Keele , UK.|e Collaboration for Leadership in Health Research and Care , West Midlands , UK.
Carolyn
C
Chew-Graham
D000328:Adult; D000368:Aged; D004739:England; D005260:Female; D006282:Health Personnel; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology* / Q000534:rehabilitation*; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care; D010361:Patients; D011369:Professional-Patient Relations; D036301:Qualitative Research
Health professionals; Multiple Sclerosis; mental health; patient experiences; qualitative; staff perspectives