APPENDIX 31
Memorandum by The Disability Partnership
(MH 80)
MENTAL HEALTH IN PRIMARY CARE
In the context of bringing services closer to people
and their communities, it is important to identify obstacles which
may prevent or hinder this development. What follows is a summary
of discussions I have had with service users and health professionals
in North Staffordshire.
The users are very clear that there continue
to be major difficulties in getting a substantial number of GPs
to understand the importance of primary care in mental health.
The National Service Framework is quite specific on some of the
issues, and there now appear to be a number of projects ongoing
in different parts of the country which are related to implementation.
From the users perspective they would be interested
in helping with three areas. These are:
(1) General education/orientation of primary
care staff around mental health issues. This would involve ensuring
that staff have basic information on depressive conditions, anxiety,
psychosis and so on. They wish to distinguish between helpful
and unhelpful responses to people coping with mental health problems,
to lessening stigma etc. They feel that there is some scope for
user trainers doing work in this area with primary care staff.
(2) Development of mental health oriented
services at primary level in a way that is fairly independent
of secondary services. They believe that there is some scope for
developing both individual and group-based services. Counselling,
for example, can be provided either through a community psychiatric
nurse or through the use of voluntary sector counsellors. Other
possibilities for group-based work within a practice would be
in areas such as anxiety management, stress management, coping
with depression, support for carers, understanding psychosis,
and so on.
(3) Working in conjunction with secondary
services. The need here seems to centre on the development of
effective pathways into secondary care. The establishment of an
early intervention approach to psychosis would be a useful area
of focus, but this would depend on GPs being sensitive to mental
health issues and to there being a fairly clear interface between
the primary and secondary sectors. The scope here seems to be
for identifying and implementing early indicator packages and
for establishing clear pathways of communication and referral.
(4) Other possibilities were discussed, such
as user representation at PCG level, user input into training/orienting
packages for primary care staff, user support/participation in
group-based services, and user involvement in service evaluation.
May 2000
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