The effectiveness of a primary care mental health service delivering brief psychological interventions: a benchmarking study using the CORE system

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Abstract:

High demand for psychological therapies in primary care has led to increased interest in the effectiveness of brief interventions. Our aims were to (1) profile patients and their presenting problems accessing a new Primary Care Mental Health (PCMH) service; (2) evaluate the effectiveness of the PCMH service in terms of patient outcomes; and (3) compare service parameters with those derived from national primary care counselling. The PCMH service was delivered in 54 general practitioner (GP) practices and provided mental health assessment, brief psychological interventions (usually up to six sessions), and onward referral to specialist services where required. Data were routinely collected over a 34-month period regarding (1) access to the PCMH service (number of patients referred, demographics, non-attendance rates, assessment outcome and completion of treatment) and (2) patient outcome using the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE). Outcome data were compared with a national dataset from 33 primary care counselling services. In total 6750 patients were referred to the PCMH service and 5539 had been discharged by the end of the evaluation. The non-attendance rate for assessment was 26.1%. One in five patients referred to the service completed therapy sessions. Outcomes of treatment were comparable with primary care counselling data. Patients choosing to complete treatment after three sessions achieved the greatest gains on average. Attrition is a key problem for efficient mental health service delivery in primary care. Evaluating this new service against national comparators of more established service delivery is a clinically useful method for monitoring outcomes of brief interventions in primary care.

Keywords: BENCHMARKING; BRIEF PSYCHOLOGICAL INTERVENTIONS; CORE SYSTEM; CORE-OM; PRIMARY CARE

Document Type: Research Article

Publication date: December 1, 2005

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