Opinion: The Case for Mental Health Practitioners in General Practice

In April 2021, the first mental health practitioners (MHPs) started working in GP practices across the 19 primary care networks covering Norfolk and Waveney. We’ve never looked back.

It was the first stage in implementing our plans to transform mental health care in primary care across the region. Our vision, informed by people with lived experience and experts from across health, social care and community sectors, was to use PCNs in the region to provide ‘wrap around’ mental health provision for all GP practices, and dramatically reduce the time people are waiting for mental health care.

The majority of our MHPs are Band 6 and 7 mental health nurses, with some from other backgrounds such as social work. We also recruited several Band 8 PCN service managers to oversee the teams – all practising clinicians with significant experience in mental health.

There was understandable hesitation on the part of the local Trust concerned about their own workforce shortages, so we started by piloting the scheme in five sites. The idea being that by placing these professionals upstream in general practice, at the front door of the NHS, they will ease pressures longer term.

Patient feedback has been excellent. They’re getting direct contact with an MHP and the appropriate support they need from their own surgery, usually within a week or two. People only need to tell their story once because we use a single trusted assessment, and they are involved in monitoring their progress through a system called DIALOG+, which maps the patient’s own goals.

Having MHPs working in our practices is vital. This is why we’ve supported the No Time To Wait campaign, which has gained cross-party backing from MPs, calling for every GP practice to have a mental health nurse.

Alongside this, we invested in a mental health diploma for primary care clinicians. This has created a really engaged group of clinicians with an interest and passion for mental health across the region. We hold a monthly ‘lunch and learn’ webinar and keep everyone informed of changes that are happening through a quarterly newsletter.

We invested in online counselling platforms, five mental health support hubs offering walk-in support in a café environment seven days a week with evening ‘sanctuaries’ until midnight, two short-stay crisis houses where people in distress who would have ended up in secondary care can stay for up to five days, and a ‘mental health’ car, jointly with the ambulance service, so mental health distress calls can be managed in patients’ own homes.