Improving Access to Psychological Therapies (IAPT) has potential but is not sufficient: How can it better meet the range of primary care mental health needs?

2021 ◽  
Author(s):  
Carla Martin ◽  
Zaffer Iqbal ◽  
Nicola D. Airey ◽  
Lucy Marks
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Needs ◽  
Mental Health Needs ◽  
Primary Care Mental Health ◽  
Psychological Therapies

scholarly journals Evaluation of a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care: the role of Primary Care Mental Health Specialists

2017 ◽  
Vol 18 (04) ◽  
pp. 344-353
Author(s):  
Kate Hamilton-West ◽  
Sarah Hotham ◽  
Wei Yang ◽  
Julie Hedayioglu ◽  
Charlotte Brigden
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Secondary Care ◽  
Unit Cost ◽  
Well Being ◽  
Safety Net ◽  
Health Needs ◽  
Mental Health Needs ◽  
Primary Care Mental Health

Aim We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care. Background Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required. The two-year pilot, across six Clinical Commissioning Groups in South East England, began in March 2013. Methods Interviews were conducted with all PCMHS employed in the pilot service (n=13) and a sample of service users (n=12). The views of professionals working alongside the service, including GPs, Psychiatrists and Mental Health Nurses, were captured using a brief online questionnaire (n=50). Time and Activity Recording Sheets were used to capture data required for economic analysis. Findings Our findings indicate that the service is working well from the perspective of patients; staff employed within the service and professionals working alongside the service. Patients described the service as a ‘safety net’ they could fall back on in case of difficulties, whereas staff used the analogy of a ‘bridge’ to describe the way the service improved communication and collaboration between the various professionals and organisations involved in the patient’s care. Improvements in well-being were seen to result from increased support for those transitioning from secondary to primary care, a more pro-active approach to relapse prevention and increased engagement in daily activities. Each PCMHS covered 36 patients in a one-month period, with a unit cost of £73.01 per patient.

scholarly journals Unmet mental health needs in the general population: perspectives of Belgian health and social care professionals

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Eva Rens ◽  
Geert Dom ◽  
Roy Remmen ◽  
Joris Michielsen ◽  
Kris Van den Broeck
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
General Population ◽  
Mental Health Care ◽  
Unmet Needs ◽  
Health Needs ◽  
Mental Health Needs ◽  
Epidemiological Research ◽  
Unmet Mental Health

Abstract Background An unmet mental health need exists when someone has a mental health problem but doesn’t receive formal care, or when the care received is insufficient or inadequate. Epidemiological research has identified both structural and attitudinal barriers to care which lead to unmet mental health needs, but reviewed literature has shown gaps in qualitative research on unmet mental health needs. This study aimed to explore unmet mental health needs in the general population from the perspective of professionals working with vulnerable groups. Methods Four focus group discussions and two interviews with 34 participants were conducted from October 2019 to January 2020. Participants’ professional backgrounds encompassed social work, mental health care and primary care in one rural and one urban primary care zone in Antwerp, Belgium. A topic guide was used to prompt discussions about which groups have high unmet mental health needs and why. Transcripts were coded using thematic analysis. Results Five themes emerged, which are subdivided in several subthemes: (1) socio-demographic determinants and disorder characteristics associated with unmet mental health needs; (2) demand-side barriers; (3) supply-side barriers; (4) consequences of unmet mental health needs; and (5) suggested improvements for meeting unmet mental health needs. Conclusions Findings of epidemiological research were largely corroborated. Some additional groups with high unmet needs were identified. Professionals argued that they are often confronted with cases which are too complex for regular psychiatric care and highlighted the problem of care avoidance. Important system-level factors include waiting times of subsidized services and cost of non-subsidized services. Feelings of burden and powerlessness are common among professionals who are often confronted with unmet needs. Professionals discussed future directions for an equitable mental health care provision, which should be accessible and targeted at those in the greatest need. Further research is needed to include the patients’ perspective of unmet mental health needs.

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