Serious Mental Health Problems in the Community: Policy, Practice, and Research

By Charlie Brooker; Julie Repper | Go to book overview

CHAPTER 5
The Primary/Secondary
Care Interface

Elizabeth Armstrong


KEY ISSUES

INTRODUCTION

In the last few years, as successive reforms have taken place within the National Health Service and Social Services, the role of primary care professionals, GPs, practice nurses and others, in the care of people with serious enduring mental illness has become much more obvious. * Frequent exhortations in government documents for all agencies concerned to work together in providing care has made secondary care services and local authority services more aware of the role of GPs, but it has also brought more tensions. GPs have been reluctant to take on what is widely perceived as more work for no additional reward, and professionals from the secondary care sector have found that working with GPs and primary care teams is not necessarily straightforward.

This chapter is concerned with primary care and the part which primary care teams play in the provision of care for mentally ill people. Although concentrating on those with serious mental illness, as that is currently defined, it also acknowledges the fact that the majority of people with any degree of mental health problem are cared for within the primary care system. The first half of the chapter looks at mental health and illness in primary

____________________
*
People registered with a GP are normally described by primary care doctors and nurses as 'patients'. Health visitors, who work with well people and families, usually refer to their 'clients'. In this chapter these conventions have been followed. 'Service user' is a term rarely employed in primary care settings.

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