Improving primary care mental health: survey evaluation of an innovative workforce development in England

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Abstract:

Objectives Primary care provides the bulk of care for common mental health problems, but problems with access to effective treatments exist. Changes to workforce and skill mix are one method of improving services. The NHS Plan proposed a new paraprofessional worker, the primary care mental health worker (PCMHW). However, the introduction of this role raised interprofessional tensions and concerns about quality, effectiveness of care and retention. This study aimed to evaluate the effectiveness of the PCMHW policy.

Methods Evaluation of the policy was conducted using a postal questionnaire of the first cohort of workers. Results from the survey were compared with original policy goals and current treatment guidelines.

Results Fewer PCMHWs were employed than initially planned, and 40% reported an intention to seek other work within the NHS. Approximately two-thirds managed patients, but access was often restricted (half of patients were reviewed by a specialist mental health professional). Types of patients seen and interventions provided were generally in line with current guidelines. Integration of PCMHWs into primary care was a significant predictor of important aspects of the role.

Conclusions Although generally successful, some aspects of implementation have faced more barriers than others. The results may have important implications for workforce developments in the NHS and beyond.

Keywords: GRADUATE PRIMARY CARE MENTAL HEALTH WORKER; MENTAL HEALTH; PRIMARY CARE; WORKFORCE

Document Type: Research Article

Publication date: December 1, 2005

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