Delivering effective mental health therapies in primary care for anxiety and depression on a group or self-guided basis

It is a historic time for mental health, as the NHS celebrates its 70th year, NHS England is undertaking an ambitious programme to transform mental health services, and to provide equal status to mental and physical health. In this blog, Dr John Hague, clinical mental health lead at Ipswich and East Suffolk CCG, points out that with nine out of ten adults with mental health problems supported in primary care, co-location of mental health therapists is a way of maximising the effectiveness of healthcare support.

One of the really important messages is to emphasise the effectiveness of evidence-based, low intensity talking treatments delivered in GP practices.

There is a perception among some GPs, nurses and patients that one-to-one treatments are the only valid mental health treatment, and that’s just not true. We need to challenge this thinking which is rooted in a past model that revolved around ‘counselling’ and the term ‘practice counsellor’.

I would advocate more mental health therapies being offered in primary care on a group or guided self-help basis – for example for anxiety or depression among patients who have long-term conditions including diabetes, chronic obstructive pulmonary disease (COPD) or cardiac disease.

Co-location and therapy groups in practices are ways of increasing both the workforce and patients’ understanding of the effective mental health therapies in primary care pathways.

Although there can sometimes be barriers to co-location, such as accommodation issues or the availability of a room, mental health therapists are just as valuable in a surgery as the work that nurses and GPs themselves do. If the Improving Access to Psychological Therapies (IAPT) service is seeing a patient then it is freeing up the GPs and nurses to do other work. So why not do it? There is no reason why not.

Evidence-based low intensity treatments are effective in terms of patient recovery and for most issues offer the most rapid, sure-fire chance of recovery.

Dr John Hague

Based at The Derby Road Practice in Ipswich, Dr Hague’s main interest is in mental health in primary care, and the provision of high quality mental health care. Dr Hague was GP Clinical Lead for the Improving Access to Psychological Therapies (IAPT) programme at NHS East of England between 2008 and 2011 – a role in which he delivered an IAPT service to between 11 and 13 Primary Care Trusts. He is a General Practitioner appraiser for NHS England. Having gained more than 30 years’ experience as a GP at the Derby Road Practice in Ipswich, he now works there as a salaried GP.

Dr Hague is a member of the Clinical Executive at Ipswich and East Suffolk CCG, and has been appointed Clinical Mental Health Lead for North East Essex and Suffolk STP. He has written a number of professional publications including The Neglected Majority (The Centre for Mental Health), November 2005 (co-author).

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