08 • Careers


GPs with a special interest in mental health are ideally placed to provide vital advice and support to meet increasing patient demand


A HEALTHYM O


NE in four people will experience a mental health problem in any given year, research suggests, with 90 per cent of those making primary care their first port of call for help. It is not surprising, then,


that as many as a third of GP consultations involve a mental health component, with 61 million antidepressant prescriptions administered in England in 2015. The Royal College of GPs advise doctors to


consider the mental health of a patient “in every primary care consultation”, and highlight the serious impact of mental health problems in contributing to disability, unemployment and social exclusion. GPs have a key role in recognising and


responding to patients’ mental as well as physical health needs but 2016 figures from the charity Mind show that in England, on average, only 46 per cent of trainee GPs undertook a training placement in a mental health setting. With demand continuing to rise, there is no better time to develop a special interest in this challenging field.


Entry and training There are a number of ways to undertake training as a GP with a special interest (GPwSI) in mental health, both practical and theoretical. These are set out in detail in the RCGP’s Guidance and competences for the provision of services using practitioners with special interests: mental health.


Examples include: • Experience of working in relevant departments


• Self-directed learning (with supporting evidence)


• As a GP specialist trainee undertaking a six-month specialist attachment


• Attachment to a mental health provider unit or under the supervision of a specialist practitioner


• As part of a recognised university training course.


Good communication and the ability to be


empathetic and non-judgemental with patients, carers and colleagues are among the key characteristics for a GPwSI in mental health. Other skills practitioners may have include leadership/coordinating care, managing clozapine in the community, physical health monitoring and understanding the special needs of care relevant to special circumstances and special groups, such as: • Elderly care and mental health


• Maternal and post-natal care • Providing care within a custodial setting


• Management of delivery of mental health care


• Mental Health Act (Section 12) approval. GPwSIs are expected to maintain their


competences by keeping a personal development portfolio. It’s also recommended to work regularly within the specialist area to experience a varied case mix, be actively involved in local mental health specialist services, and contribute to local clinical audits.


The job GPwSIs in mental health may choose to work in a general practice setting but their skills can be applied further afield, such as in specialist medication clinics, residential care, prison healthcare, elderly care homes and other mental healthcare settings. The type of care specialists can provide is


broad and can include complex therapy for people with mental health problems and those with significant co-morbidities. This may involve areas such as eating disorders, pre and peri-natal mental health, early intervention in psychosis services and medical input to multidisciplinary primary care mental health teams. They may also help those with medically unexplained symptoms, treatment resistant symptoms, long-term medical conditions, and in older people’s mental health. GPwSIs can also provide specific psychological therapeutic interventions such as CBT, systemic or family therapy. GPs with a special interest are often active


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