Launer, John (2011) What would an ideal mental health service for primary care look like? London Journal of Primary Care, 4 (1). pp. 49-54. ISSN 1755-9146 (Print) ; 1755-9154 (Online) Full text available

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Abstract

Key messages: In order to commission an ideal mental health service for primary care, GP commissioners should challenge accepted distinctions and divisions. These include the division between mental health clinics and the GP surgery, and between short GP consultations and extended mental health ones. They also include the division between mental and physical illness, between severe and enduring mental illness and other difficulties, and between the individual and the family. GPs should also call into question the divisions between the mental, social and economic domains, between all the different mental health disciplines and ideologies, and between neighbouring localities or boroughs. Finally, they should challenge the distinctions between offering a diagnosis and treatment, and having a therapeutic conversation; and between the patient's voice and the doctor's decision-making. Why this matters to me: As a GP who is also a part-time consultant in a mental health trust, I have spent the last 15 years trying to promote innovative thinking and ways of working at the interface between primary and secondary care. In spite of all the obvious risks and constraints that will accompany GP commissioning consortia, I believe they may offer an opportunity to challenge some or all of the false divisions and distinctions that currently bedevil mental health services and often lead to fragmented, inflexible, inappropriate or poor care for patients. Mounting such challenges could lead to mental health services that were more attuned to the realities of primary care and served patients far better. The creation of GP commissioning consortia offers potential opportunities for GPs to challenge a number of divisions and distinctions that are currently taken for granted in mental health services, but may be neither necessary nor logical. I examine a range of these and suggest what GPs and patients might reasonably expect if we challenged them in order to imagine and commission an ideal mental health service for primary care. Among its features, an ideal service would cross the boundaries of mental and physical care, individual and family care, and the mental, social and economic domains. It would also transcend mental health ideologies, geographical borders and the artificial distinction between making a diagnosis, offering treatment and holding a therapeutic conversation.

Item Type:	Article
Uncontrolled Keywords:	Mental Health Services, Primary Health Care
Subjects:	Disabilities & Disorders (mental & physical) > Mental Disorders Health and Medical Sciences > General Practice Health and Medical Sciences > National Health Service
Department/People:	Honorary Staff
URI:	https://repository.tavistockandportman.ac.uk/id/eprint/1335

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