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Page 1 of 5

  • Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme
  • Siobhan Reilly, Catherine McCabe, Natalie Marchevsky, Maria Green, Linda Davies, Natalie Ives, Humera Plappert, Jon Allard, Tim Rawcliffe, John Gibson, Michael Clark, Vanessa Pinfold, Linda Gask, Peter Huxley, Richard Byng, Max Birchwood
  • Journal: BJPsych Open / Volume 7 / Issue 2 / March 2021
  • Published online by Cambridge University Press: 15 February 2021, e53
    • Article
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  • View abstract
    Background

    There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness.

    Aims

    This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK.

    Method

    We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages.

    Results

    The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years.

    Conclusions

    The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

Primary Care Mental Health
  • Primary Care Mental Health
  • 2nd edition
  • Edited by Linda Gask, Tony Kendrick, Robert Peveler, Carolyn A. Chew-Graham
  • Published online: 10 September 2018
  • Print publication: 20 September 2018
  • View description
    Around ninety per cent of all patients with mental health problems are managed solely in primary care, including thirty-fifty per cent of all those with serious mental illness. Primary care plays an increasingly essential role in developing and delivering mental health services, and in the wellbeing of communities. In this book, internationally respected authors provide both a conceptual background and practical advice for primary care clinicians and specialist mental health professionals liaising with primary care. Clinical, policy and professional issues, such as working effectively at the interface between services, are addressed, with a key focus on patient and service user experience. Following the highly successful first edition, which was awarded first prize at the BMA Medical Book Awards in the category of Primary Health Care, this fully updated volume includes new chapters on mental health and long-term physical conditions, prison populations, improving access to care and public mental health.

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