Are specialist mental health services being targeted on the most needy patients? The effects of setting up special services in general practice
Are specialist mental health services being targeted on the most needy patients? The effects of setting up special services in general practice
BACKGROUND: Around 25% of patients with psychoses lose contact with specialist psychiatric services, despite the government's policy to focus the efforts of community teams on this group.
AIM: To identify patient and practice factors associated with continuing contact and loss of contact with specialist services.
METHOD: Cross-sectional comparison was made of patients in and out of specialist contact, through detailed interviews with 102 patients among 26 south west London practices. Associations were sought between contact with specialist services and patient factors (illness severity, social functioning, quality of life, needs for care, and satisfaction with general practitioner [GP] services) and practice factors (size, location, fundholding status, training status, and the presence of mental health professionals on site).
RESULTS: Thirty-one (30%) patients were currently out of specialist contact. No significant differences were found between those in and out of contact on any measures of diagnosis or psychiatric history. Those in contact had significantly more symptoms, poorer social functioning, poorer quality of life, and more needs for care. The proportion out of contact was significantly higher in two practices that had employed their own mental health professionals to provides services on site for severe mental illnesses. Two factors remained significant predictors of contact in a logistic regression model: whether or not the patient's practice offered a special service on site, and greater patient needs for care.
CONCLUSIONS: Secondary mental health services are being targeted towards the more needy patients. The provision of special services in practices can shift care further away from secondary care while still meeting patients' needs.
community-based mental health teams, specialist services, psychiatric services, primary care
121-126
Kendrick, T.
c697a72c-c698-469d-8ac2-f00df40583e5
Burns, T.C.
9d77b78c-7026-4b8d-a669-0318242bd48e
Greenwood, N.
499b047b-f94d-4d8e-a5e9-79770c5d107d
Smith, P.W.F.
753f7c7b-d43d-4c10-bc12-c7351c2e5a4d
2000
Kendrick, T.
c697a72c-c698-469d-8ac2-f00df40583e5
Burns, T.C.
9d77b78c-7026-4b8d-a669-0318242bd48e
Greenwood, N.
499b047b-f94d-4d8e-a5e9-79770c5d107d
Smith, P.W.F.
753f7c7b-d43d-4c10-bc12-c7351c2e5a4d
Kendrick, T., Burns, T.C., Greenwood, N. and Smith, P.W.F.
(2000)
Are specialist mental health services being targeted on the most needy patients? The effects of setting up special services in general practice.
British Journal of General Practice, 50 (451), .
(PMID:10750209)
Abstract
BACKGROUND: Around 25% of patients with psychoses lose contact with specialist psychiatric services, despite the government's policy to focus the efforts of community teams on this group.
AIM: To identify patient and practice factors associated with continuing contact and loss of contact with specialist services.
METHOD: Cross-sectional comparison was made of patients in and out of specialist contact, through detailed interviews with 102 patients among 26 south west London practices. Associations were sought between contact with specialist services and patient factors (illness severity, social functioning, quality of life, needs for care, and satisfaction with general practitioner [GP] services) and practice factors (size, location, fundholding status, training status, and the presence of mental health professionals on site).
RESULTS: Thirty-one (30%) patients were currently out of specialist contact. No significant differences were found between those in and out of contact on any measures of diagnosis or psychiatric history. Those in contact had significantly more symptoms, poorer social functioning, poorer quality of life, and more needs for care. The proportion out of contact was significantly higher in two practices that had employed their own mental health professionals to provides services on site for severe mental illnesses. Two factors remained significant predictors of contact in a logistic regression model: whether or not the patient's practice offered a special service on site, and greater patient needs for care.
CONCLUSIONS: Secondary mental health services are being targeted towards the more needy patients. The provision of special services in practices can shift care further away from secondary care while still meeting patients' needs.
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Published date: 2000
Keywords:
community-based mental health teams, specialist services, psychiatric services, primary care
Identifiers
Local EPrints ID: 34758
URI: http://eprints.soton.ac.uk/id/eprint/34758
ISSN: 0960-1643
PURE UUID: 270fe988-1646-4660-bd89-9132447d52ec
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Date deposited: 28 Jul 2006
Last modified: 23 Jul 2022 01:43
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Contributors
Author:
T.C. Burns
Author:
N. Greenwood
Author:
P.W.F. Smith
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