Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation

Justin Grayer,Judy Leibowitz,Marta Buszewicz,John Cape,Lisa Orpwood

doi:10.1186/1471-2296-9-27

Abstract

BackgroundPatients with psychosocial problems may benefit from a variety of community, educational, recreational and voluntary sector resources, but GPs often under-refer to these through lack of knowledge and time. This study evaluated the acceptability and effectiveness of graduate primary care mental health workers (GPCMHWs) facilitating access to voluntary and community sector services for patients with psychosocial problems.MethodsPatients with psychosocial problems from 13 general practices in London were referred to a GPCMHW Community Link scheme providing information and support to access voluntary and community resources. Patient satisfaction, mental health and social outcomes, and use of primary care resources, were evaluated.Results108 patients consented to take part in the study. At three-month follow-up, 63 (58%) had made contact with a community service identified as suitable for their needs. Most were satisfied with the help provided by the GPCMHW in identifying and supporting access to a suitable service. There was a reduction in the number of patients with a probable mental health problem on the GHQ-12 from 83% to 52% (difference 31% (95% CI, 17% – 44%). Social adjustment improved and frequencies of primary care consultations and of prescription of psychotropic medications were reduced.ConclusionGraduates with limited training in mental health and no prior knowledge of local community resources can help patients with psychosocial problems access voluntary and community services, and patients value such a scheme. There was some evidence of effectiveness in reducing psychosocial and mental health problems.

Highlights

Patients with psychosocial problems may benefit from a variety of community, educational, recreational and voluntary sector resources, but GPs often under-refer to these through lack of knowledge and time
The present study aimed to evaluate the feasibility of such a role being undertaken in primary care settings by a graduate primary care mental health worker (GPCMHW) with limited previous training in mental health, and no previous knowledge of local community resources [8]
Information about community services was provided to 88% of patients, and the GPCMHW arranged to accompany 11 patients to the community services suggested

Summary

Introduction

Patients with psychosocial problems may benefit from a variety of community, educational, recreational and voluntary sector resources, but GPs often under-refer to these through lack of knowledge and time. This study evaluated the acceptability and effectiveness of graduate primary care mental health workers (GPCMHWs) facilitating access to voluntary and community sector services for patients with psychosocial problems. Whilst some may be helped by referral to counselling or mental health services, others can potentially benefit from a variety of community, educational, recreational and voluntary sector resources It can often be difficult for primary care teams to help people access these resources appropriately, due to lack of knowledge about what is available and insufficient time to facilitate this access [2,3,4,5]. In a randomised control trial of a 'referral facilitation' scheme in Bristol, referred patients had improved mental health outcomes [7]

Methods

Results

Discussion

Conclusion