We have been working at the university medical centre one day a week since February this year and between us , the clinical nurse specialist and occupational therapist have seen a total of 200 patients .”
P
rimary care providers – specifically General Practitioners ( GPs ) – play a crucial role in managing mental health conditions and around 90 % of people with depression and mental health conditions are treated within primary care services in the UK ( Ramanuj et al 2019 ).
GPs are involved in screening , diagnosing and treating depression and prescribing medication . They may recommend counselling therapies and refer patients to specialist mental health services when needed . They also monitor psychiatric risk , ensure follow-up care and address social vulnerabilities impacting mental wellbeing .
Primary Care Networks ( PCNs ) facilitate collaboration between healthcare professionals and organisations to deliver co-ordinated care , including community mental health teams and voluntary organisations ( Personalised Care Institute 2023 ; NHS England 2022 ).
This integrated approach aims to provide comprehensive and holistic care for individuals with mental health conditions , including severe mental illnesses , by addressing both physical and mental health needs ( Kendrick et al 2022 ).
The mental health practitioner role
Within my area , the GP operates as the first point of contact for patients with mental health concerns . This first appointment usually lasts for 10 minutes and can be conducted either over the telephone or in person .
During the GP consultation , a patient may complete the Patient Health Questionnaire-Nine ( PHQ-9 ) ( Kroenke et al 2001 ), a self-reporting tool to screen patients for major depressive disorders .
Following the assessment , the GP might then signpost patients to other services within primary care . The referral information is then sent to a generic inbox , where the occupational therapist and clinical nurse specialist triage the tasks based on priority and allocate as per clinical need .
If it is related to medication , the clinical nurse specialist would take over care , as it is within their scope of practice .
The UK has experienced a significant increase in adults seeking attention deficit hyperactivity disorder ( ADHD ) diagnosis , with a 400 % rise since 2020 , according to the ADHD Foundation ’ s own reported figures . Consequently , some of the referrals we receive are screenings for ADHD and autism spectrum disorder ( ASD ) and the aim is to contact people within a week of receiving a referral .
On receiving a referral , we conduct a preliminary telephone call with the patient to
We have been working at the university medical centre one day a week since February this year and between us , the clinical nurse specialist and occupational therapist have seen a total of 200 patients .”
arrange the first appointment , which can be conducted either face to face at their university medical centre , or over the telephone , based on their preference . During this call , we outline what to expect during the first appointment .
To avoid missed appointments , we use the Accurx platform to send text message reminders out . This is important because , according to NHS England ( 2019 ), approximately one in 20 GP appointments are missed without sufficient notice .
Our multidisciplinary team appointments are generally longer than the GP appointment slots ; this allows us time to build a therapeutic rapport with the patient .
Mood scores are collected at the beginning and end of the intervention , to determine whether the patient ’ s mood has improved or declined during the treatment process . Patients are asked to score their mood on a scale between one and 10 , where the lowest score equals not helpful and the highest is extremely helpful .
The Model of Human Occupation ( MOHO ) screening tool ( Kielhofner and Burke 1980 ) is used during the initial assessment . In some cases , we complete short-term intervention of two to four sessions with patients through setting smart goals ( Brown and Chien 2010 ), based on the patient ’ s desires and interest , and signposting and reviewing how that can help health and wellbeing .
For patients not to be overwhelmed with paper at the end of the appointment , we send goals to their mobile devices . This reduces their anxiety about remembering the information and it also reduces the risk of breaches to confidentiality ( RCOT 2021 ).
We maintain strong connections with the university student wellbeing services and during appointments we provide a QR code so that patients can use mobile devices to access any
December 2023 OTnews 25