As GP practices are now required to offer online consultation options under the NHS ‘digital first’ approach, researchers wanted to understand whether these tools work well for people needing mental health support. The National Institute for Health and Care (NIHR)- funded research drew on in-depth interviews with 20 primary care practitioners and 21 patients from Bristol and the surrounding area.
Key findings
Online tools help encourage self reflection but may limit disclosure: Participants reported that online consultation tools prompted reflective thinking about their mental health and supported easier symptom disclosure. However, many patients expressed concerns about who might read the information they submitted in the online form.
Risk of creating barriers to care: Some patients found online tools difficult to use, particularly those with lower digital literacy or mental health literacy, risking reduced access to mental health support. Practitioners also highlighted increased difficulty in assessing patient risk when the information provided by patients in online forms was limited.
Potential impact on continuity of care: The study found that online tools may disrupt the continuity of care provided in general practice. Practitioners noted that reduced continuity can make it harder to provide personalised care, particularly when dealing with sensitive mental health concerns.
Useful for some but not a universal solution: Despite challenges, both patients and practitioners acknowledged benefits: online tools can be more accessible than telephone calls for individuals experiencing anxiety or depression, and they may offer valuable background information for clinicians before a subsequent appointment with the patient.
Recommendations
The study concludes that online consultation tools should remain one option to access primary care among several options, not a mandatory first step for patients seeking mental health support. To avoid worsening inequalities, healthcare practices should, ensure that phone and in-person consultations are also readily accessible, alongside advising patients how best to use online tools and who will read the information they submit within them.
Dr Charlotte Archer, Research Fellow in Primary Care Mental Health at the Centre for Academic Primary Care, University of Bristol and lead author, said: “Online tools can offer real advantages for some patients with anxiety or depression, especially those who find phone calls difficult, but they cannot replace the nuanced understanding practitioners gain through spoken interactions. Ensuring equitable access means keeping multiple avenues to access care open.”
Paper: The use of online consultation tools for common mental health conditions in UK primary care: A qualitative interview study of patient and practitioner perspectives. Charlotte Archer, David Kessler, Louise Ting, Nicola Wiles and Katrina Turner. BMC Primary Care.