Mental Health Service Provision and the Primary Health Care Team
| Pages | 8-16 |
| Date | 01 September 1996 |
| Published date | 01 September 1996 |
| DOI | https://doi.org/10.1108/13619322199600025 |
| Author | Steve Onyett,Frankie Pidd,Alan Cohen,Edward Peck |
| Subject Matter | Health & social care |
8 The Mental Health Review 1:3 ©Pavilion Publishing (Brighton) 1996
Mental Health Service Provision and
the Primary Health Care Team
Steve Onyett, Senior Research Fellow
UNIVERSITY OF KENT (FORMERLY CMHSD)
Frankie Pidd, Associate Consultant
CMHSD
Alan Cohen, Primary Care Adviser
CMHSD
Edward Peck, Director
CMHSD
GP-fundholding is starting to bring about
an inexorable shift in the control of mental
health services to primarycareand increased
interest in the development of mental health services
in primary care settings. Already, the traditional
delineation of services into ‘primary’ and secondary’
appears less valid. This article provides an overview
of the variety of potential approaches to linking
mental health services to primary care and some of
the important cultural and organisational tensions
that characterise the field.
Defining our terms
It is important to remember that primary health care
is not synonymous with general practice and general
practice is not synonymous with the work of GPs,
otherwise many important services (such as pharmacy)
may be overlooked. Family health services (FHS)
include general practice, dentistry,pharmacy and
optical services; community health services (CHS)
include district nursing, health visiting, chiropody,
community physiotherapy and occupational therapy,
midwifery and so on. However, the traditional
boundaries between primary and secondary care are
shifting, eroding accepted definitions. We therefore
need to establish the essential characteristics and
functions of the primary and secondary care sectors
(see Figure One).
FEATURE
Primary Care Secondary/Specialist/Tertiary Care
●direct/open access ●referral usually necessary (sometimes several)
●community-based ●hospital/institution/community-based
●generalist ●specialist
●initial treatments, treatments of simpler problems ●sophisticated interventions and treatment regimes
●preventative care (screening etc) and continuing ●acute care, continuing care
care (long-term conditions)
●knowledge of the patient/family important ●expert knowledge of the disease and associated
problems
●gate-keeps wide range of health and social care ●gate-keeps targeted specialist care
●networks of manysmall/medium sized providers ●few large providersusually dominant
COMPARING PRIMARY AND SECONDARY/SPECIALIST/TERTIARY CARE
FIGURE ONE
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