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It is recognised that training is required for staff working with people with a diagnosis of personality disorder, as it poses challenges requiring particular skills and…
It is recognised that training is required for staff working with people with a diagnosis of personality disorder, as it poses challenges requiring particular skills and abilities (National Institute for Mental Health in England, 2003a). The proposal to train graduate primary care mental health workers (GPCMHWs) to work with the client group met with some scepticism by senior clinicians. However, the experience of providing training and supervision to the graduate primary care mental health workers to work with clients with personality disorder in Camden and Islington has proved positive. Several characteristics of the GPCMHWs identified in the training literature might contribute to this positive experience. Those factors include cognitive ability, motivation to learn, age, and attitudes. Initial findings from the evaluation of the training shows that graduate workers respond positively to the training, showing improvements in self‐rated knowledge and skills relating to working with the client group, and an eagerness to learn more. The relevance of this to the personality disorder capabilities framework are described.
The scale of current demand on primary care services from people seeking help with common mental health problems places enormous pressure on the existing front line workers…
The scale of current demand on primary care services from people seeking help with common mental health problems places enormous pressure on the existing front line workers in general practice. The paucity of training opportunities and competing pressures to deliver improved services across a range of general practice targets remains a major challenge for primary care professionals. The impact of government policy, to improve both access to and choice of treatments, has raised public expectations.The commissioning of the graduate workforce, the graduate worker in primary care mental health (GWPCMH), commenced in 2002, in response to the publication of target numbers detailed in the Priorities and Planning Framework, (DoH, 2002). It signalled a determination to expand the workforce provision and improve the quality of care for service users with common mental health problems.This paper examines the scale of common mental health problems, the policy response and the commissioning process. Particular attention is given to examining the barriers that have been shown to affect implementation, identifying the key influencers and the resources required to train these workers.
This paper is the first of two linked articles that explores a shared learning approach to developing a module on collaborative working for graduate primary care mental…
This paper is the first of two linked articles that explores a shared learning approach to developing a module on collaborative working for graduate primary care mental health workers (PCMHWs). The article describes how the policy context shaped the training agenda and how the requirements of the roles and responsibilities in respect of collaborative practice were mapped against the Ten Essential Capabilities of the mental health workforce. The process of constructive alignment (Biggs, 1999) that involves matching teaching and assessment methods to intended learning objectives was used alongside evidence from the research literature on systems working and interprofessional education to inform the design of the modular curriculum in more detail.The second paper will provide an in‐depth evaluation of the module as it was delivered using a framework derived from the academic literature (See Bailey & Littlechild, 2001 and Barr et al, 1999a; 1999b). Included in the evaluation will be a discussion of how the context of workforce change in primary care mental health influenced the training inputs together with a reflection on the training methodologies employed to promote collaborative practice. Different levels of evaluating the training will be discussed including the impact of the module on practice outcomes such as attitudes of the workers and changes in their practice. The lessons learned from the evaluation will be discussed in relation to the models of best practice emerging from the IPE literature and the challenges of implementing a new workforce strategy in primary care mental health.
This paper provides initial findings from a pilot to introduce graduate mental health workers into primary care, child and adolescent mental health services (CAMHS) across…
This paper provides initial findings from a pilot to introduce graduate mental health workers into primary care, child and adolescent mental health services (CAMHS) across three localities in the north west of England in the UK. The progress of the pilot was monitored by gathering information from students, managers, supervisors and mentors regularly throughout the 12 month period, during which the pilot cohort were being formally trained. The potential of the new role of primary care graduate mental health workers to address problems of volume and access to services, particularly how the role might contribute to developing nonspecialist primary care services, is considered.
This paper focuses on a shared learning module on collaborative practice for graduate primary care mental health workers as a case study in formative evaluation that…
This paper focuses on a shared learning module on collaborative practice for graduate primary care mental health workers as a case study in formative evaluation that combines qualitative and quantitative methods. Evaluation data are collected across four levels in an attempt to explore issues relating to:• curriculum content• training methods and design• PCMHWs' experiences of the training• outcomes in respect of attitude change and self‐reported changes in knowledge, skills and practice.The paper draws on a review of inter‐professional education undertaken by the British Education Research Association (BERA) to explore what interactive methods of learning are employed in the delivery of the module as a means of fostering improved collaborative practice that can be transferred from the learning environment to the primary care mental health setting. According to Barr et al (2005, p31) inter‐professional education takes place on ‘occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care’.The paper concludes that although limited in its generalisability and the extent to which changes in attitudes and practice can be attributed to the training intervention, there are some useful lessons to be learned for planning and delivering training to promote collaborative working within primary care mental health.
This paper highlights the social context of common mental disorders in primary care and the paucity of evidence relating to effective social interventions. It introduces…
This paper highlights the social context of common mental disorders in primary care and the paucity of evidence relating to effective social interventions. It introduces the ABC‐E Model of Emotion, which combines social interventions with psychological therapy, and discusses how the implementation of the new role of graduate primary care mental health worker (GPCMHW) provides an opportunity for holistic practice in helping individuals experiencing mild to moderate mental health difficulties in primary care. It provides a case example of the implementation of the ABC‐E model and makes recommendations for further research including the evaluation of the model and GPCMHW training programmes.
The current focus on psychological well‐being and the treatment of people experiencing common mental disorder in primary care is of interest to health professionals and…
The current focus on psychological well‐being and the treatment of people experiencing common mental disorder in primary care is of interest to health professionals and economists alike (Centre for Economic Performance Mental Health Policy Group, 2006). This brings with it an important opportunity to consider how services for people living with long term medical conditions may benefit from developments in widening access to psychological therapies. The National Service Framework for Longterm Conditions (DoH, 2005a) aims to improve the quality of life for people living with chronic medical conditions. Further to this, NICE Guidelines for the Management of Chronic Obstructive Pulmonary Disease (COPD) (NICE, 2004a) specifically focuses attention on quality of life issues for COPD sufferers and the influence of co‐morbid mental disorder on the ability of individuals to optimise selfmanagement of their condition. By examining issues relating to co‐morbidity of common mental disorders within the long‐term condition of COPD this paper concerns itself with how the agenda for widening access to psychological therapies delivered through a stepped model of care and the introduction of new mental health workforce roles such as community matrons, case managers and primary care graduate mental health workers (PCGMHWs) provides an opportunity for primary care services to integrate mental health care into chronic disease management for COPD, which in turn may provide a model for the development of services for other long‐term medical conditions.
Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems…
Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.