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Benefits of primary care mental health workers 'small and modest'

By Lilian Anekwe

An international gold-standard review has questioned the value of having primary care mental health workers delivering psychological therapies at GP practices.

Primary care mental health workers are increasingly deployed in primary care to deliver psychological interventions, partly as a cheaper alternative to clinical psychologists.

But the Cochrane review, by researchers at the National Primary Care Research and Development Centre, found the benefits of on-site primary care mental health workers on GP prescribing or referral patterns were ‘small and modest' at best.

One analysis in the systematic review of 42 studies found primary care mental health workers reduced the rate of GP consultations by nine consultations a year.

Though study found that referral to a mental health worker reduced the likelihood that a GP would prescribe a psychotropic medication, but the impact on prescribing costs was again small and four studies found no statistically significant difference in prescribing.

The evidence for the effect on referrals was mixed, with some studies reporting decreases in referral rates while one found on-site mental health workers might actually increase certain types of mental health referrals.

Study leader Dr Peter Bower, a reader in primary care mental health research at the National Primary Care Research and Development Centre, concluded: ‘The evidence provides some support for the hypothesis mental health workers reduce consultation rates, psychotropic prescribing and mental health referrals.

‘But the effects are modest. There is evidence that on-site mental health workers do not impact on prescribing behaviour and the impact on referral rates is very inconsistent.'

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