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‘We should not go back to a mental health worker in each practice’, says NHS chief



GPs may soon be able to access more locally based mental health services for their patients, but should not be reliant on having mental health workers based in practices, following comments from the national lead on mental health in England.

Dr Geraldine Strathdee, NHS England’s national clinical director for mental health, called for more access to local mental health services ahead of the launch next Monday of NHS England’s long-awaited independent Mental Health Taskforce report

They also follow calls from RCGP chair Professor Maureen Baker to have ‘mental health workers based in practices for real time referrals and support’, under a series of ‘emergency’ measures the College is working on with NHS England chief Simon Stevens.

Speaking at a Westminster Health Forum event on priorities in mental health services, Dr Strathdee said: ‘I must admit I get slightly depressed when I hear people say we’re going to have a “mental health worker” in primary care, because what we don’t want to do is go back to non-evidenced interventions.’

Dr Strathdee added that this risked going back to historical situations where ‘you have your own community psychiatric nurse in primary care who has a caseload of 100’, which she said would mean ‘you cannot give the psychological interventions, or the case management people need’.

Dr Strathdee told Pulse each area should instead offer services according to their local population’s needs – so that, for example, GPs with high numbers of patients with psychosis should have access to community ‘enhanced psychosis’ doing outreach work.

She said such models typically involved ‘having one half day a week of a GP with a special interest in psychosis, and a practice nurse who is dedicated to helping people and working in collaboration with peer support workers, family and the third sector to go people’s homes help them socialise, help them have a healthy lifestyle and get to their appointments’.

Dr Strathdee said there were a range of models that could be offered, including group therapy done in practice clinics, to boost the offer of psychological treatments for people with long-term conditions and comorbid depression or anxiety – which is expected to form a key plank of the Mental Health Taskforce report.

She said: ‘In many places in England they are doing this in quite a smart way and looking at where would be most helpful to do things in groups – for example I’ve been to places where there are 16 people in a “Living well after stroke group”, integrating physiotherapy and psychological therapy in a large GP health centre.’