Scottish Primary Care Mental Health Research and Development Programme

1
Scottish Primary Care Mental Health Research and
Development Programme

• Margaret Maxwell and Allyson McCollam

2
5 years ago..

• Problem of definition
• PC-MH does not generally reflect individual
  problems but encompasses complex or multiple
  issues
• Primary careis not a neat high ground of
  well-defined symptoms, but a messy swamp of
  experiences and interpretations. (Lester et al,
  2004)

3
Service user experiences and expressed needs

• My step-dad didnt want me in the house, he just
  wanted me out of the road, I wasnt his child to
  look after, and he was physically abusing me as
  well, and so it had a mental effect on me as
  well, so it wasnt a very healthy environment for
  me to stay in, and it came to the decision I had
  to leave, it wasnt really that good for me
  there. (male, 20s)

4
Service user experiences and expressed needs

• developing a social network of support
• information provision on activity resources
• help and encouragement in returning to
  education/meaningful activity
• I mean sometimes I phone the SamaritansIm not
  going to commit suicide or anything like that, I
  dont know why I do it and theyre not really
  very helpful to mewhen I sit here I havent got
  anyone to phoneIm alone, loneliness is a
  terrible thing. (male 50s)
• Well I suffer depression, so it actually helps
  me a bit to make the effort to get up in the
  morning, get changed and then go to it, go to the
  training course, it gives me the motivation to
  get up in the morning and go to try and help me
  get back into work again. (male)

5
Service user experiences and expressed needs

• tackling local crime, drugs and vandalism to
  promote an environment conducive to good mental
  health
• I shouldnt be in this area, I need to get a new
  house, this area affects me and allThis is
  better than watching the telly, because were
  high up we can look down and see them all
  fighting, and running about with blades..and
  hitting peoples windows with bricks and all that
  (male, 40s)

6

• Im sorry to tell you if you come back to me in
  5 years I will tell you exactly the same as I do
  nownothing will change. (male, 50s)

7
What is needed?

• Building an environment conducive to good mental
  health
• Holistic assessment of needs
• Increased systematic access to community or
  voluntary resources and non-medicalised
  interventions
• Services that are uncomplicated to access,
  recognising gateways to services other than the
  GP
• Overcoming challenges to working together to
  address the needs of the whole person

8
Since then

• National Programme to Improve Mental Health and
  Wellbeing
• Doing Well by People with Depression
• Community Health Partnerships
• Integrated Care Pathways
• MH and LTC Collaboratives
• HEAT Targets
• Equally Well

9
What has the programme been doing?

• Self help and self management (evaluations of
  Doing Well, Peer support)
• Models and approaches to support for people with
  complex problems (Living Better, LLTTF for
  CHD/Diabetes, Depression and long term
  incapacity)
• Whole systems / public health approaches (EAAD,
  prescribing patterns, addressing inequalities )
• Partnership development (CHP seminars, Resource
  papers, Living Better)
• Community based models / non medicalised
  approaches (Social prescribing)

10
What has the programme been doing? Examples

• Resource documents
• (2007) 9 Steps to Improving Scotlands Mental
  Health in Primary Care.
• (2006) Resource Paper for Community Health
  Partnerships Promoting mental health and
  preventing common mental health problems.
• (2006) Resource paper on Social Prescribing
• Seminars/Workshops
• CHP workshops to raise awareness of the Mental
  Health agenda in Primary Care
• Seminar on recovery narratives
• Workshop on complexity tool for primary care
  (holistic assessment)