Can Adhering to Clinical Communication Guidelines Promote Trust, Liking and Respect for General Practitioners and Willingness to Discuss Depression? A Theory-Based Test

Despite its prevalence, individuals can be reluctant to discuss depression with their general practitioners (GPs). Effective communication strategies can help but their relative impact on patients’ willingness to discuss their mental health and the underpinning theoretical mechanisms is unclear. Using the Morality–Agency–Communion (MAC) model as the theoretical basis, a UK-based online sample (N = 329) rated their respect, liking and trust for GPs (MAC model outcomes), along with their perceived competence, warmth, morality and assertiveness (MAC model trait mechanisms) and willingness to discuss depression (downstream outcome) before and after reading six hypothetical scenarios based on UK communication guidelines. Compared to baseline, following each recommendation improved all outcomes. Liking was the most consistent mediator on willingness to discuss depression; trust, and to a lesser extent, respect, also played a role. Trait mechanisms differed by outcome: warmth was the most robust mediator for liking; for trust, competence; for respect, morality was key. Of the six communication approaches, allowing patients time to describe and discuss any problems or concerns was the most impactful. Consistent with the MAC model, this study suggests that following communication guidelines can improve how much GPs are seen as moral, warm and competent and, in turn, how much they are respected, liked and trusted. GPs could utilise these approaches more consistently to increase how much they are liked and trusted as well as their patients’ willingness to discuss depression within their consultations.