Abstract
OBJECTIVE--To describe the nature and distribution of mental health professionals working on site in general practices. DESIGN--Postal questionnaire and telephone interview survey. SETTING--English and Welsh general practices. SUBJECTS--1880 general practitioners, of whom 1542 (82%) responded. MAIN OUTCOME MEASURES--Prevalence, types, and distribution of mental health professionals working on site among general practices. Factors predicting the presence of mental health professionals on site. RESULTS--The number of practices reporting the presence on site of each type of professional were 528 for community psychiatric nurses; 266 for practice counsellors; 177 for clinical psychologists; 132 for psychiatrists; 96 for psychiatric social workers; and 45 for psychotherapists. Mental health professionals tended to cluster together in practices more often than expected by chance alone. Practice characteristics which independently predicted the presence of a mental health professional on site were having four or more partners; being a training practice; and running stress, bereavement, or other mental health clinics. The proportions of practices with mental health professionals on site varied significantly among health regions. There was no association between the presence of mental health professionals on site and the location of practices, the social class mix of patients, or the estimated percentage of elderly patients or patients of non-European origin. CONCLUSIONS--Mental health professionals tend to cluster together, with a preponderance in larger training practices. Specialist mental health care provision within general practices is unevenly distributed. Further research is needed to determine whether this uneven distribution reflects differences in need or inequalities in the provision of mental health services.
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Selected References
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- Jarman B., Bosanquet N. Primary health care in London--changes since the Acheson report. BMJ. 1992 Nov 7;305(6862):1130–1133. doi: 10.1136/bmj.305.6862.1130. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sibbald B., Addington-Hall J., Brenneman D., Freeling P. Counsellors in English and Welsh general practices: their nature and distribution. BMJ. 1993 Jan 2;306(6869):29–33. doi: 10.1136/bmj.306.6869.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strathdee G., Williams P. A survey of psychiatrists in primary care: the silent growth of a new service. J R Coll Gen Pract. 1984 Nov;34(268):615–618. [PMC free article] [PubMed] [Google Scholar]
- Thomas R. V., Corney R. H. A survey of links between mental health professionals and general practice in six district health authorities. Br J Gen Pract. 1992 Sep;42(362):358–361. [PMC free article] [PubMed] [Google Scholar]
- Tyrer P. Psychiatric clinics in general practice. An extension of community care. Br J Psychiatry. 1984 Jul;145:9–14. doi: 10.1192/bjp.145.1.9. [DOI] [PubMed] [Google Scholar]
- Tyrer P., Seivewright N., Wollerton S. General practice psychiatric clinics. Impact on psychiatric services. Br J Psychiatry. 1984 Jul;145:15–19. doi: 10.1192/bjp.145.1.15. [DOI] [PubMed] [Google Scholar]
- Williams P., Balestrieri M. Psychiatric clinics in general practice. Do they reduce admissions? Br J Psychiatry. 1989 Jan;154:67–71. doi: 10.1192/bjp.154.1.67. [DOI] [PubMed] [Google Scholar]
- Wooff K., Goldberg D. P. Further observations on the practice of community care in Salford. Differences between community psychiatric nurses and mental health social workers. Br J Psychiatry. 1988 Jul;153:30–37. doi: 10.1192/bjp.153.1.30. [DOI] [PubMed] [Google Scholar]