A commissioner’s guide to primary care mental health Strengthening mental health commissioning in primary care: Learning from experience
ACKNOWLEDGEMENTS The London Mental Health Strategic Clinical Network would like to thank all stakeholders and partners for their time and commitment in assembling the primary care mental health guide.
EXECUTIVE SUMMARY - Lessons for commissioners
A special thank you goes to all case study contacts for their contributions to the directory. The case study directory is a rich resource for commissioners and others, which would not have been possible without the many submissions – some at short notice!
PRIMARY CARE MENTAL HEALTH Where should mental health care take place? What is primary care mental health? Prevention and early intervention in primary care Managing physical and long term conditions in primary care Primary care mental health commissioning Bringing about practical change in primary care Primary care standards
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LEARNING FROM PRACTICE
COMMUNITY BASED MENTAL HEALTH CARE Lesson 1: Local champions drive forward implementation Lesson 2: Effective Health and Wellbeing Boards can be enormously helpful Lesson 3: Primary care education and training will enable change Lesson 4: Money needs to move with the patient Lesson 5: Co-production will deliver ownership by people with mental illness and carers as well as better services
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ACCESSIBLE MENTAL HEALTH SERVICES Lesson 6: The service needs to cover all ages Lesson 7: A mosaic of services needs to be provided to wrap around individuals and carers
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CO-ORDINATED MENTAL HEALTH CARE Lesson 8: Specialists’ time should be freed to look after people with complex needs and to be available for rapid advice and help for primary care Lesson 9: IT enabled communications between primary care and mental health is vital for a fully functioning service Lesson 10: Managing long term conditions
PRIMARY CARE MENTAL HEALTH DIRECTORY London-wide and national case studies International case studies APPENDIX A
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The team acknowledges Public Health England for contacting wider mental health wellbeing networks in assembling case studies. We are grateful to those who took the time to offer insightful comments on earlier drafts including Dr Geraldine Strathdee, Dr Rhiannon England, Dr Peter Ilves, Deborah Cohen, Ian Walton, Dr Alex Warner, Sophie Corlett (Mind) and Victoria Bleazard (Rethink). Particular thank you goes to Dr Rhiannon England and Dr Lise Hertel, valued members of the primary care Mental Health SCN team. Both are clinical champions, proactive GP leaders who drive transformation change locally. Finally, huge thanks to Andrew Turnbull, Mental Health, Dementia and Neuroscience SCN Lead, Helen O’Kelly, Mental Health, Dementia and Neuroscience SCN Assistant Lead and the London SCN team who have all helped keep this project on track and produce the excellent result presented here. Very special thanks go to Stefanie Radford, Mental Health Senior Project Manager, whose tenacity and enthusiasm have spurred her to undertake an immense amount of research, including literature reviews and building essential relationships in devising an amazing directory of case studies. Without her sterling work it is unlikely this report would have seen the light of day.
TABLE OF CONTENTS
In setting up London’s Mental Health Strategic Clinical Network it was clear that something different was needed; something that represented more directly the different narratives that exist around mental health and illness. Primary care is one of the most important of these and I think that