Targeted Approach to Providing Child and Adolescent Mental Health Education to GPs

AIMS: The aim of this project was to construct and deliver an educational session for general practitioners (GPs) in local Primary Care Networks on challenging child and adolescent mental health conditions. It was hypothesized that delivering targeted teaching sessions, supported by the same quiz applied before and after, would demonstrate an effective and repeatable method of improving GPs’ knowledge about these conditions. Since the COVID-19 pandemic, demand on both Child and Adolescent Mental Health Services (CAMHS) and GPs has reached unprecedented levels. Compounding this load, half of all referrals written by GPs to CAMHS are rejected, which prolongs the time a young person is under GP care, delaying specialist intervention. Unfortunately, during GP training exposure to CAMHS is limited and dedicated teaching is often insufficient. As a step towards addressing this challenge, a comprehensive teaching session combining didactic and socratic methods was devised and tested. METHODS: The teaching session comprised the presentation, diagnosis, and first steps in management of four challenging conditions in children: autism, eating disorders, depression, and emotional dysregulation. A quiz with multiple-choice answers was administered before and after the presentation, addressing each of the four conditions. The data collection took place between December 2022 and January 2023. A total of 29 pairs of quizzes were completed by GPs. Due to the type and size of data collected, a non-parametric bootstrap resampling method was used to compare the before-and-after scores for each topic and overall score. RESULTS: For the 29 pairs of quizzes, mean differences and 95% confidence intervals (CIs) were calculated between before-and-after scores, for each topic and for the total. All 4 topics showed statistically significant mean improvements: autism 1.3 CI: [0.9 , 1.8 ], eating disorder 1.8 CI: [1.4 , 2.3 ], depression 1.4 CI: [1.0 , 1.7 ] and emotional dysregulation 1.7 CI: [1.4 , 2.0 ]. The total mean improvement was 6.2 CI: [5.5 , 6.8 ] out of a maximum 16 points. CONCLUSION: These targeted educational sessions suggest it is possible to make reliable improvements in GP knowledge across a variety of topics. With child and adolescent mental health demands at record levels, a more focused approach of the kind considered here may offer a model for training elsewhere. As an indication of the impact of this approach, further sessions on other topics have been requested by the GP teaching leads.