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A different ball game altogether: staff views on a primary mental healthcare service

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Qualitative interviews of staff were used to evaluate a primary care mental health service that combined replacement and consultation–liaison models. An urban general practice in the UK, with a high prevalence of severe mental illness, expanded the primary care team with two occupational therapy staff, extended the general practitioner role, and arranged visits from a psychiatrist, in order to provide care for people with enduring psychotic conditions.

The staff identified key features of the new service. These process components were: expansion of the primary team (extended roles and new staff); the primary care base; the nature of the interventions (care management and occupational therapy); and the focus on the complex needs of people with severe and enduring problems. Staff reported the impact these features had on clients and themselves. Clients had improved access to care, had their social and practical needs met, and engaged in community integration. These benefits to clients had a positive effect on staff morale, as did staff feelings of being valued and being involved in a dynamic enterprise. Staff also appreciated how extension of their roles had utilised and developed further their existing skills and knowledge. The features of the new service combined to improve communication and the co-ordination and continuity of care. However, the primary care-based mental health staff reported feeling isolated and the stress of competing demands within their multifaceted roles. A challenge for similar initiatives was identified as finding ways to provide a wide skill mix, staff support and staff cover within a small primary care team.


Document Type: Research Article

Publication date: June 1, 2004

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