Mental Health in Primary Care A New Approach

by Elder, Andrew; Holmes, Jeremy

• ISBN13: 9780198508946
• ISBN10: 0198508948
• Format: Paperback
• Copyright: 2002-11-07
• Publisher: Oxford University Press

Summary

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 guidancein 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' group, 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 practiced in the primary care setting, away from psychiatric institutions, and adapted to the realities of primary care, where distress does not easily fir 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 GP's, 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.

Table of Contents

List of contributors	vii
Introduction: The Need for a New Approach	1	(10)
Andrew Elder
Jeremy Holmes
Part I: In the consulting room
In the consulting room	11	(16)
Sam Smith
Body and mind	27	(18)
Richard Westcott
Biological and narrative time in clinical practice	45	(10)
Brian Hurwitz
Mental illness, general practice, and society	55	(16)
Iona Heath
Part II: Reflective practice
The difficult patient	71	(18)
Eia Asen
Stress, strain, and burnout: support and supervision	89	(16)
Jane Milton
Training for GPs	105	(16)
Paul Sackin
Part III: Mental health thinking in the surgery
The practice as an organization	121	(14)
John Launer
Systemic family practice in primary care	135	(12)
Hilary Graham
Robert Mayer
Therapists and counsellors in primary care	147	(20)
Mary Burd
Jan Wiener
Part IV: Perspectives from secondary care
Postnatal depression	167	(12)
Maret Dymond
Lynne Murray
Peter J. Cooper
Eating disorders	179	(10)
Ulrike Schmidt
Management of serious mental illness	189	(20)
Christine Wright
Tom Burns
Suicide, deliberate self-harm, and severe depressive illness	209	(12)
Jonathan Evans
Substance misuse	221	(20)
Ilana Crome
Ed Day
Psychopharmacology	241	(18)
Adrian Feeney
David Nutt
Trauma and post-traumatic stress disorder	259	(16)
Gwen Adshead
Psychological therapies	275	(10)
Glenys Parry
John Cape
References	285	(28)
Index	313