Managing severe mental illness in primary care
Rethink Mental Illness is the largest national mental health membership charity, and the majority of our members are affected by severe mental illness such as schizophrenia and bipolar.
We know that many people with severe mental illness can be successfully managed in primary care. However, we also know that improvements can be made to the way these people are diagnosed and managed in terms of their mental and physical health – often small adjustments that have a big impact in reducing referrals to secondary services and co-morbidity.
We are already providing GPs with a range of support to meet this challenge, including:
There are lots of ways we could work together. Please get in touch with us to discuss how we can help manage severe mental illness in primary care in your area - call
0300 5000 927 or email
commissioning@rethink.org
Case study: Leicestershire Mental Health Facilitator service
The continuing success of the ‘Good Thinking’ service is a tribute to the commitment of a group of clinicians determined to break down the barriers between primary and secondary care. This could not have been achieved without the support of a third sector organisation committed to care models that really work for service users and a private sector body committed to primary care commissioning.
Dr Terri Eynon, Chair of the Leicestershire IAPT Consortium Board
GPs in Leicestershire have designed an innovative service to manage people with severe mental illness in primary care. GPs on the Leicestershire IAPT Consortium Board recognised that, along with patients with anxiety and depression, there were other patients with mental illness whose care either did or should take place in primary care. They worked with Assura Leicestershire LLP practice based commissioning group, Leicestershire Partnerships Trust and the charity Rethink Mental Illness – the ‘Good Thinking’ partnership - to develop and deliver a Mental Health Facilitator (MHF) service.
The service, commissioned by Leicestershire County and Rutland PCT as part of the IAPT service, addresses the needs of patients with non-psychotic and chaotic and challenging disorders (care cluster 8) – who are often unreachable by secondary care but present frequently to their GP - and the general care needs of stable individuals on the Severe and Enduring Mental Illness (SEMI) register who are being managed in primary care (care cluster 11). The Mental Health Facilitators work with the primary care teams to determine, on a practice by practice basis, how the overall aims can best be met. Their role can therefore include individual work with identified patients, work with practice nurses to help SEMI registered patients receive generalist care, work on mental health reviews, supporting GPs with chaotic patients unsuitable for secondary care or supporting patients awaiting a CMHT assessment.
In the year after the implementation of the MHF service (09/10) Leicestershire County and Rutland was the highest performing PCT across the region for indicator MH09 -
“The percentage of patients with schizophrenia and bipolar affective disorder and other psychoses with a review recorded in the previous 15 months. In the review there is evidence that the patient has participated in routine health promotion and prevention advice appropriate to their age and health status”.
Community health networks study
We have just launched a new research study looking at how people with severe and enduring mental health problems build and use community health networks to support their health and well being. The study, run by Rethink Mental Illness, Peninsula Medical School Plymouth, Imperial College London and Kings College London, aims to map how individuals, health services and other community organisations interconnect, and to measure the health benefits of these networks. The two-year study will produce tools and resources for individuals and health services on how community health networks can best be supported, and you can follow its progress by registering for its community health interest network – email
commissioning@rethink.org
