Dr Charles Heatley is a senior partner at Birley Health Centre, in south-east Sheffield, which has a practice population of approximately 8,300 people, with an above-average prevalence of chronic diseases such as coronary heart disease, chronic obstructive pulmonary disease (COPD), and diabetes. He sets out some of the benefits of co-locating mental health therapists in GP surgeries.
Our practice has five partners, and a range of attached staff including Improving Access to Psychological Therapies (IAPT) practitioners who provide integrated mental health therapy, nurses, midwives, a pharmacist and health visitors.
The IAPT mental health service has been based here since the programme was established in 2008, and before that psychological therapy was provided by a practice counsellor. We seized the opportunity when IAPT came along as part of our integrated health care offer for our patients.
The great thing about it is I can talk to any of the four or five mental health therapists who work at the practice. Those one-to-one discussions are useful and have led to the GPs at the practice working on different ways of referring patients to the IAPT service, as well as patients’ self-referrals.
Sometimes, a face-to-face conversation with a member of the IAPT team can also resolve an issue such as whether a patient meets the criteria for secondary mental health treatment. Without that co-location of mental health expertise, the alternative could be a more time-consuming paper-based information exchange in order to resolve an issue.
Another benefit of integrated working is the co-recording of patient information using the System 1 method. The record created every time a patient sees an IAPT therapist gives me, as their GP, a valuable insight into the nature of the work that is taking place. For instance, this may be the patient’s agreed goals, or details of their cognitive behavioural therapy (CBT). From this information I can see how they are progressing which is helpful when they come to see me at their next appointment. I can also encourage people to maintain the work they do under supervision from the psychotherapist, such as achieving goals, and behavioural exposure. This insight into the conversations that are taking place with patients is helpful in understanding the psychological treatment models that are used. It is evident the style of work is consistent and clear.
In my experience, co-locating mental health therapists in GP surgeries, and broadening the range of services for patients, means local health services are better equipped to deal with patients’ physical and mental health needs. By intervening at an earlier stage and addressing common mental health issues the IAPT programme is helping to improve patients’ health outcomes.