Chronic obstructive pulmonary disease: the case for widening access to primary mental health care and opportunities for new ways of working
| Pages | 3-11 |
| DOI | https://doi.org/10.1108/17556228200700002 |
| Published date | 01 June 2007 |
| Date | 01 June 2007 |
| Author | Amy Blakemore,Clare Baguley |
| Subject Matter | Health & social care |
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Chronic obstructive pulmonary disease:
the case for widening access to primary
mental health care and opportunities for
new ways of working
Amy Blakemore, Primary Care Mental Health Worker, Bury Primary Care Trust, Greater Manchester
Clare Baguley, Programme Director, Advanced Practice Interventions for Mental Health (Primary Care), University
of Manchester
The Journal of Mental Health Workforce Development Volume 2 Issue 1 June 2007 © Pavilion Journals (Brighton) Ltd
Abstract
The current focus on psychological well-being and
the treatment of people experiencing common
mental disorder in primary care is of interest to
health professionals and economists alike (Centre for
Economic Performance Mental Health Policy Group,
2006). This brings with it an important opportunity to
consider how services for people living with long
term medical conditions may benefit from
developments in widening access to psychological
therapies.
The National Service Framework for Long-
term Conditions
(DoH, 2005a) aims to improve the
quality of life for people living with chronic medical
conditions. Further to this, NICE Guidelines for the
Management of Chronic Obstructive Pulmonary
Disease (COPD) (NICE, 2004a) specifically focuses
attention on quality of life issues for COPD sufferers
and the influence of co-morbid mental disorder on
the ability of individuals to optimise self-
management of their condition. By examining issues
relating to co-morbidity of common mental
disorders within the long-term condition of COPD
this paper concerns itself with how the agenda for
widening access to psychological therapies delivered
through a stepped model of care and the
introduction of new mental health workforce roles
such as community matrons, case managers and
primary care graduate mental health workers
(PCGMHWs) provides an opportunity for primary care
services to integrate mental health care into chronic
disease management for COPD, which in turn may
provide a model for the development of services for
other long-term medical conditions.
Key words
primary care; COPD; co-morbid mental disorder;
psychological therapies; stepped model of care;
primary care graduate mental health workers
(PCGMHWs)
Introduction
COPD is an umbrella term used to describe a number of
chronic lung disorders, such as chronic bronchitis,
emphysema and chronic obstructive airways disease
(Chief Medical Officer, 2004). It is a progressive and
disabling condition, which is primarily related to
smoking, however,it can also be caused by occupational
exposure to inhaled dusts (Fehrenbach, 2003). COPD
prematurely kills 30,000 people each year in the United
Kingdom (British Thoracic Society, 2006). It is estimated
that by 2020, COPD will be the world’sfifth ranking cause
of burden of disease (Murray & Lopez, 1997). It is the third
leading cause of death in the United Kingdom (CMO,
2004) and is highly associated with social inequalities
(BTS, 2006). The British Thoracic Society (2006) estimates
the overall economic costs of lung diseases totals £6.6
billion, however,in comparison to 21 other chronic
illnesses that affect the older population, COPD currently
receives the least amount of funding in relation to illness
burden (Gross et al,1999).
Co-morbidity in COPD sufferers
COPD is often characterised by breathlessness on physical
exertion, general shortness of breath, coughing, wheezing
and increased sputum production (Ferenbach, 2003).
These symptoms can lead to a reduced ability and
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