‘Fantastic book’ brims with solutions approach

What do I say next? Everyday Mental Health Conversations in Primary Care. A Practical Guide by Sophie Jadwiga Ball and Liz Moulton is a fantastic book. I’m very proud of my colleague Sophie for creating a guide that is so practical in helping us answer a very relevant question.

The book is co-authored with GP Dr Moulton, who is well known in the UK for The Naked Consultation: A Practical Guide to Primary Care Consultation Skills (published by CRC Press, 2007). Dr Moulton starts this book with a great consultation summary, including very specific skills for data gathering in the mental health context. She then talks about management in a much broader way than diagnosis, medication and referral to talking therapy. The reader is left with a whole lot of general strategies for responding to mental distress.

Sophie, a specialist GP, is well known in New Zealand. She was the RNZCGP lead medical educator for Auckland South and was also involved in designing the Wellness Support Model of Care, a prizewinning mental health model for use in primary healthcare with Counties Manukau DHB.

Sophie focused on writing the main part of What do I say next? (published by CRC Press, 2024) and it is very different to other books I have read about mental health issues in general practice.

It is practical, based on case examples exploring what might be asked or said, so it feels like real life.

We are given many options, examples of words to say, and simple frameworks for thinking about our approach.

It is not about diagnosis but about how to have a conversation, even a brief one, that makes a difference to that person today.

It does not come from a deficits model where we seek out the person’s problems. The book is quickly solutions-based but always with the solutions being generated by the patient rather than offered by the doctor. It is a very empowering approach.

The patient goes away with tools, maybe some small actions to take, different ways of thinking if thoughts recur, a sense of what is important to them, a plan to stay safe and some follow-up.

I spend a lot of my week teaching communication skills and I have learned many new things from this book. Honestly, I will be trying some new things tomorrow. It empowers the doctor as much as the patient.

What do I say next? should be read by every GP, but at the very least, every GP educator and every GP teacher and every GP registrar. It is a good investment because it is a book you will go back to many times. I’ve already dipped back in twice to check things I want to learn.

What do I say next? was published in the UK, so it’s harder to find in New Zealand book shops. I suggest we start asking for it to get it on the shelves. I got my copy through Christchurch based Scorpio Books because I wanted it quickly, but you can get it from Routledge with free shipping in seven to 10 days. An e-book is also available.

I hope Sophie will be invited to run workshops or webinars based on the skills in this book.

Even the most experienced GPs ask themselves, ‘What do I say next?’

Lucy O’Hagan is a medical educator and specialist GP working in the Wellington region