There are many GPs who have had absolutely no training in psychiatry whatsoever for whom discussing with people with mental illness problems how they feel is very frightening. They don’t want to open up a can of worms and discover things that they don’t know. I think that there is a lot to be said for having a service that actually helps GPs gain more confidence rather than doing things for them but enabling them to grow into their own abilities as primary care psychiatrists. My name is Debbie Wheatley I’m a Mental Health Facilitator working within a team of about 10 Mental Health Facilitators working across Leicestershire county. We see patients who are initially becoming unwell with their mental health, so we will be assessing them and referring them on to secondary care, we’ll also have patients that are coming back down, so they will be referred back to primary care and referred to the Mental Health Facilitator. Sometimes those patients just need regular monitoring. We monitor their physical health on an annual basis if they are on the severe mental illness register. Sometimes they need to go back to secondary care if they relapse or if there are any issues with medication, so we can facilitate that as well. One of the problems that as a GP I certainly experienced before this service was set up is spending three hours on the phone of an afternoon trying to work out which of the many different services available in our provider trust I could actually refer this patient to that I had in front of me. What your Mental Health Facilitator will do for you is see patients and assess them for you in your surgery or at home and come to a decision with you as a GP about what you think would be the most helpful path for this person to help them to move forward. The service users I think are relieved to have somebody that they can speak to for longer than ten minutes, which is what a usual GP appointment would be, and if it takes a few different appointments or a few different assessments then that’s fine as well. They don’t want to have to go to a ‘mental health building’, they want to be able to be seen in their GP practice or at home, because we can do that as well, we do see people at home, especially if they are housebound- a lot of people we see have a lot of physical health problems as well. I had a conversation with a psychiatrist last week about somebody that I’d referred and he just said to me that he’s so relieved to have people like us in primary care because they see somebody maybe every three months whereas if there are problems, which there have been with this patient that I was talking to him about, he knows that something will be done and he’ll be contacted and that person can be seen quickly. Mental Health Facilitators really do add value. I had a lady who was constantly being admitted to hospital, constantly calling the GP, calling the ambulance service and generally calling for help. What a Mental Health Facilitator did in this case was to work with the chronic conditions nurse and helped us to have, and the women’s relatives, to have a plan for how they could help her to calm down at home and to recognise what was happening to her. In my role as a Mental Health Facilitator I can see the difference that the role has made very much from the comments of service users saying how much they value the service, also from GPs and psychiatrists saying how much they value the service and how they don’t think they could do without it. What is different about the mental health facilitator service is that it doesn’t come in from the outside as a package that says this is what will work for you it comes at it from the other end and says what would you like to achieve? I think that’s a different way round to how services are created and developed but one I think that other services can learn from.
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