The Management of Mental Disorders in the Community: The View From Primary Care
| DOI | https://doi.org/10.1108/13619322199600031 |
| Pages | 29-32 |
| Published date | 01 September 1996 |
| Date | 01 September 1996 |
| Author | Ruth Ward,Jan Scott |
| Subject Matter | Health & social care |
The Mental Health Review 1:3 © Pavilion Publishing (Brighton) 1996 29
Ruth Ward, MRCPsych, MRCGP, Clinical
Assistant in Psychiatry
STGEORGE’SHOSPITAL, NORTHUMBERLAND
Jan Scott, MD, FRCPsych, Professor
UNIVERSITY DEPARTMENTOF PSYCHIATRY, ROYAL VICTORIA
INFIRMARY, NEWCASTLE UPON TYNE
Introduction
Some nine out of ten individuals identified by
GPs as having a mental disorder are treated
by the primary health care team (PHCT). The
relocation of former long-stay residents of psychiatric
hospitals to the community has increased the number
of people suffering from severe mental disorders
needing additional primary care input. There is a
widely recognised need to develop and evaluate
GP skills in managing psychiatric patients. The
Health of the Nation and the Primary-Care Led NHS
documents stress this crucial role. Are PHCTs ready
to meet this challenge? What models can be instigat-
ed to help primary care colleagues undertake this
task?
Many of the published examples of good (and
poor) practice in mental health care provision
describe services from a secondary care perspective.
We thought it important to review the strengths and
weaknesses of the system from a primary care view-
point. The practice studied was typical of those
found in large cities in the Midlands. There were
three GP partners, a practice nurse and a reception-
ist. The practice population of 4,200 was distributed
across catchment areas served by two mental health
teams.
The study
The project work was carried out by a qualified
psychiatrist undertaking 12 months additional
training in general practice on a vocational training
scheme. No additional resources were available and
The Management of Mental Disorders
in the Community: The View From
Primary Care
FOCUS ON…
ABSTRACT
This study examines the community management of mental disorders from a primary care
perspective. The primary care response to individuals with mental health problems of all
severities and the secondary care response to referrals were reviewed. The data was used to
inform a discussion of the primary team’s views on mental health care. The primary care team’s
suggestions for improvements in mental health care provision included prospective development
of mental ill-health registers, proactive recall appointment systems and locally-owned treatment
guidelines with protocols for shared care with one CMHT. This approach bears striking similarities
to other chronic disease-management models used in primary care.
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