Mental Health in Primary Care

Mental Health has finally come home to primary care, where 90% of all patients with psychological difficulties are diagnosed and treated, and where Governments increasingly see the bulk of mental health commissioning and practice as belonging. This book, whose contributors uniquely include leading figures from the world of both primary care and psychiatry, brings together the best of contemporary psychiatry with a deep understanding of the realities, challenges and opportunities of general practice. The book is divided into four parts. The reader is taken from the first-hand experience of the encounter with the psychiatric patient in the GP consulting room, through the stresses and strains of such work, to the wider primary care mental health team of counselling, family therapy and group dynamics, and finally to specific disorders such as psychosis, eating disorders, depression, suicide, and trauma as they present in the primary care setting. The book ends with practical guidance in the use of psychotropic drugs and psychological treatments in primary care. The tone throughout is influenced by the editors' background , one a GP, the other a psychiatrist, in psychotherapy and 'Balint' groups, which places the doctor's own feelings and aspirations centre stage, no less than those of the patient. The book offers new ideas in two ways. First, in that it looks at how cutting edge psychiatry can be applied and practised in the primary care setting, away from psychiatric institutions, and adapted to the realities of primary care, where distress does not easily fit into predetermined categories derived from secondary care. Second, because the editors, possibly unfashionably, believe that, faced with an ever-expanding, protocol-driven, standardised medical culture, the concepts and ideas of group dynamics and counter-transference need to be rediscovered if primary care is to be effective. In sum, this book is an essential vade-mecum for all primary care mental health workers, whether GPs, psychologists, nurses, psychiatrists, psychotherapists or counsellors. It contains practical guidance and holds onto the vision that GP, patient, family and practice team must work together.