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Primary Care and General Practice successful in helping those with mental health problems

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Monday 10 August 2009 12:15pm

GPs and other primary health care professionals can provide effective care to people suffering from a wide range of mental health problems, a new report has concluded.

The report, released from the Minister of Health's office, was produced by a team of researchers from the Departments of Primary Health Care and Public Health at the University of Otago, Wellington.

It evaluated the Ministry of Health-funded Primary Mental Health Initiatives (PMHIs) between June 2005 and November 2007 and concluded that GPs, nurses, and talking therapists working as a team can effectively recognise and manage mild to moderate common mental health conditions.

The study team used a mixture of research methods to explore how well 26 different initiatives, involving 42 of the 80 Primary Health Organisations (PHOs) in New Zealand, cared for those suffering from mental health problems.

A total of 16,007 people were seen across the different initiatives and the report found that up to 80% of people benefited from using the services and were satisfied with them.

"Just under half (46%) New Zealand's population will suffer from mental health problems and mental illness sometime in their lives, with most suffering from anxiety, depression or substance-use conditions," says principal investigator Professor Tony Dowell.

"The great majority of these problems will be mild to moderate conditions, and it's important that primary care has the resources to help support them. The fact that 80% of those we investigated showed improvement in their condition is encouraging, since we would expect at best only 30-50% of people to improve without specific interventions"

A psychiatrist on the research team, Dr Sunny Collings, felt the findings raised many issues regarding the use of psychological therapies in primary care. "We found that people showed improvement to some extent regardless of the nature of the psychological intervention. We need to explore exactly what it is that works in psychological treatment in the primary care setting and develop therapies specifically tailored to primary health care and general practice".

Academic nurse researcher Eileen McKinlay saw the study results as highlighting the need for good teamwork and training in primary mental health care. "While some GPs, nurses and therapists already have previous skills and training in mental health, there is the potential for providing new skills to primary care teams through funded interdisciplinary education."

GP researcher Dr Lynn McBain felt there were significant implications for the future organisation of practice. "The results of this study suggest that in the future there is the potential to change the balance of mental health work with practice nurses undertaking a greater role and GP's managing the co-ordination of different disciplines."

The report showed that the effect of the intervention was sustained in a six month follow up. Biostatistician Dr James Stanley highlighted the importance of being able to record the impact of the initiatives over time, and the use of measuring tools in mental health care.

Professor Dowell highlighted the importance of mental health problems in children and young people. "Given the worrying number of mental health problems in young people, and evidence indicating that adult disorders may start in late childhood and adolescence, our report suggests there should be more emphasis placed on child and youth services," he said.

He also noted that while the present funding was focused on Māori, Pacific peoples and those on low income, there was still more work to be done to improve access to services, particularly to Pacific peoples.

Professor Dowell added on behalf of the research team that overall, "The Evaluation findings provide a good platform for further developing services and providing workforce development that addresses the needs of patients with mild to moderate mental health problems in primary care."

For further information contact

Professor Tony Dowell
Department of Primary Health Care and General Practice
University of Otago, Wellington
Tel +64 4 385 5541
Email tony.dowell@otago.ac.nz

Dr Sunny Collings
Social Psychiatry and Population Mental Health Research Unit
University of Otago, Wellington
Tel +64 4 385 5541
Email sunny.collings@otago.ac.nz

Dr James Stanley
Department of Public Health
University of Otago,Wellington
Tel +64 4 385 5541
Email james.stanley@otago.ac.nz

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