I must admit I am new to this blogging thing, so please forgive me if I don’t quite adhere to blogging etiquette!
I’m a GP in Surrey Downs and clinical lead for the mental health workstream for Surrey Heartlands, and wanted the opportunity to tell people about an important new model for mental health that will sit within primary care.
Apparently, the 850, 000 people who live in the Surrey Heartlands area have relatively good mental health compared to the national average. This may well be true, but as local GP, I have seen a huge rise in the number of people with mental health issues. Talking with my fellow GPs, they too report that far more people are attending with symptoms of anxiety and depression than ever before.
Some of this relates to changes in life circumstances; being laid off, relationship breakdowns, problems paying the rent. Are we supporting these people in a way that meets their needs? Are we doing enough to prevent mental ill-heath and improve our own emotional well-being?
There is certainly increasing research to suggest there are things we can ‘do’ to help improve our mood and reduce the risk of depression (details on the Healthy Surrey website). We also have wonderful services such as ‘community connections’ which provide support and advice to people with mental health issues.
Locally we can signpost people to talking therapies (IAPT) or refer to the community mental health teams. Yet people don’t always fit neatly into these boxes and as a result their needs remain unmet. We also know that stigma around mental health still exists and carers are often finding it hard to cope. And we still don’t have that true mental/physical health integration that we need across the system.
There are also particular groups of people whose needs we are not meeting, such as the physical health needs of those with serious mental illness like schizophrenia or bipolar. People with learning disabilities who are far more likely to have anxiety and depression. People with dementia and their carers who may be struggling with very little support. And people with long-term conditions like diabetes who may feel down or anxious but are rarely asked directly about their mood.
Could there be a better way to deliver a more integrated service? I think so. At the very least we need to try. Maybe a different approach could meet these unmet needs.
So we are starting three pilots across Surrey Heartlands to integrate mental health within primary care. These pilots are being run within our primary care networks (PCNs). PCN is a relatively new term and refers to GP-registered populations of 30,000-50,000 and includes general practice, social care, partners in the community and the voluntary sector.
This new mental health pilot is building on the PCN model and will include new roles as well as links with established services. The team will include mental health practitioners, pharmacists, psychologists, peer support workers, psychiatry in-put, IAPT and the voluntary sector.
The aim is that people presenting with mental health needs in primary care find access and seeking help a positive experience and get the support they need. The model is being co-designed with stakeholders including people who use services and their carers. We have had a number of engagement events exploring what the service will look like and discussing pathways. We anticipate making changes and tweaks as we go along; the hope being that we can flex the model after its initial launch as it becomes clear what is working well and what needs modifying.
It feels like there is a shift, all be it subtle, in the public’s attitude to mental health. If we can get this new model right, we will be one step closer to integrating physical and mental health and one step further away from silo-ed working and stigma.
As a GP, my hopes for this model are simple. I want people to get the kind of support that makes a difference, that has a positive impact, that improves their mental health and keeps them well for longer.
Dr Julia Chase