Table 4 Barriers in the management of anxiety problems

GPs’ personal and practice barriers

MHPNs’ personal and practice barriers

- Insufficient time

- Insufficient expertise/knowledge

- No overview/knowledge of mental health care institutions

- Concern to damage Patient-Family-Physician relationship^b

- Limited availably of MHPN/ No other expert in general practice^b

- Insufficient time in agenda to plan patients

- Difficulty choosing best approach/management

- Not appropriate care while on waiting list

- No experience managing young children with anxiety^b

- Working with confidential information^a

Child and family barriers

Child and family barriers

- Difficult cooperation with child/family

- Unrealistic expectations of family^b

- Disagreement between GP and parents on management^a

- Child’s barrier to seek help with GP^a

- Low motivation of children

- Complex / non-supportive family situation

- Children difficulty expressing themselves / verbal approach less suitable

- Unrealistic expectations / non-proactive caregivers^a

- Difference in needs of child and parents^a

- Parents with different cultural background^a

External mental health care barriers

External mental health care barriers

- Long waiting lists for external mental health care

- Obscurity towards efficient referral process

- Low quality mental health care^a

- Long waiting lists for external mental health care

- Not covered treatment options by insurance