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Q&A MIND


in leadership and education roles, for example as a mental health champion within their own practice or wider community, and through sharing expertise with other primary care organisations or practitioners. One of the key messages in the RCGP’s 2014


statement, Care of people with mental health problems, is that: “An exploration of physical, psychological, social, cultural and spiritual issues should be integrated into both the consultation and the management of illness; cultural issues can impact on how mental health issues present and the acceptability of diagnosis.”


“ GPs have a key role in recognising patients’ mental as well as physical health needs”


The future Mental healthcare in primary care has been referred to as the “Cinderella of the health system”, but the signs suggest that change is afoot. Government policy seems to be placing a greater emphasis on mental healthcare provision, while in 2014 the RCGP made mental health and whole-person care a five- year UK-wide priority. The College says this move is “intended to encourage learning and development in mental health, as well as an environment in which quality improvement in mental health can flourish.”


Sources • RCGP – Guidance and competences for the provision of services using practitioners with special interests: mental health: tinyurl.com/glbs4fo


• RCGP 2014 statement – Care of people with mental health problems: tinyurl.com/ h8ncvk8


• RCGP mental health resources: tinyurl. com/n5dgvcu


Dr Henk Parmentier, London-based GP with a special interest in mental health


• What attracted you to mental health as a specialty? Mental health is the most common “illness” in primary care so if, as a GP, you want to help patients, you need to be aware of mental health. Mental disorders are found in all countries, in women and men, at all stages of life, among the rich and poor, and in both rural and urban settings. Up to 60 per cent of people attending primary care clinics have a diagnosable mental disorder and 90 per cent of all mental health problems are looked after in primary care. Only about 25 per cent of all people with mental health problems receive ongoing treatment and most chronic illnesses are co-morbid with mental health problems like anxiety and depression.


• What does your role involve? Seeing patients who are referred to me by my GP colleagues in the surgery where I work. I also run a specialised mental health/wellness clinic for the local GP federation. I organise educational events and lecture to clinicians about mental health.


• What do you enjoy most about the job? Seeing my patients and lecturing.


• Are there any downsides? There is a risk of being too much focused on mental health issues.


• What do you find most challenging? Closing the gap between primary and secondary care is a challenge. Another is reducing the excessive mortality for patients with a mental health illness: people with conditions like schizophrenia, bipolar disorder, and major depression die, on average, 25 years sooner than those without mental health problems.


• What about the role has most surprised you? How with simple advice and interventions you can improve health so much.


• What is your most memorable experience so far? Seeing how over time a homeless alcoholic person returned to being an independent person with a meaningful job, living by himself.


• What advice would you give to a trainee GP thinking about specialising in mental health?


Do it! Primary care mental health is the only “special interest” that will help most of your primary care patients both with physical and mental problems.


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