Exploring the prevalence and primary care management of common mental disorders in the Falkland Islands

Abstract

Aim: The aim of this study was to explore the prevalence and management of common mental disorders within primary care in the Falkland Islands. Background: Understanding population mental health in remote and rural communities is a global public health priority. With no previous community-based prevalence studies in the Falkland Islands and no understanding of the challenges faced by primary care practitioners managing common mental disorders within this remote island community, this study seeks to inform clinical practice and inform public health policy and initiatives. Methods: A multi-method approach with two separate studies was employed, combining findings from an adult population postal survey and semi-structured interviews with primary care practitioners. The population sample consisted of 979 respondents, representing 39% of the adult population. Interviews with seven primary care practitioners, three GPs and four nurse practitioners, were analysed applying thematic synthesis of themes from the literature to develop a framework of overarching themes. Findings: The prevalence of common mental disorder in the Falkland Islands is 12%, or one in eight for depression and anxiety and one in ten for PTSD. Prevalence varies in association with the demographic characteristics of the population. The study found that primary care practitioners do not routinely screen for the range of disorders, so misdiagnosis and missed opportunities to diagnosis exist. Hazardous alcohol intake is more prevalent in men and is associated with common mental disorder. Low level drug abuse is prevalent in one in twenty of the population. Conclusion: Population subgroups emerge at greater risk of common mental disorder, particularly linked to gender and age range. Community based health surveillance in the Falkland Islands is a valuable tool understanding the community and improving public mental health. Implementing routine screening in primary care practice would improve the detection of common mental disorders and associated alcohol or drug use.