Mental Health in Primary Care: A New Approach

Overview

Mental Health has finally come home to primary care, where 90% of all patients with psychological difficulties are diagnosed and treated, and where Governments increasingly see the bulk of mental health commissioning and practice as belonging. This book, whose contributors uniquely include leading figures from the world of both primary care and psychiatry, brings together the best of contemporary psychiatry with a deep understanding of the realities, challenges, and opportunities of general practice. The book is ...

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Overview

Mental Health has finally come home to primary care, where 90% of all patients with psychological difficulties are diagnosed and treated, and where Governments increasingly see the bulk of mental health commissioning and practice as belonging. This book, whose contributors uniquely include leading figures from the world of both primary care and psychiatry, brings together the best of contemporary psychiatry with a deep understanding of the realities, challenges, and opportunities of general practice. The book is divided into four parts. The reader is taken from the first-hand experience of the encounter with the psychiatric patient in the GP consulting room; through the stresses and strains of such work; to the wider primary care mental health team of counselling, family therapy and group dynamics; and finally to specific disorders such as psychosis, eating disorders, depression, suicide, and trauma as they present in the primary care setting. The book ends with practical guidance in the use of psychotropic drugs and psychological treatments in primary care. The tone throughout is influenced by the editors' background- one a GP the other a psychiatrist—in psychotherapy and 'Balint' group, which places the doctor's own feelings and aspirations center stage, no less than those of the patient. The book offers new ideas in two ways. First, in that it looks at how cutting edge psychiatry can be applied and practiced in the primary care setting, away from psychiatric institutions, and adapted to the realities of primary care, where distress does not easily fit into predetermined categories derived from secondary care. Second, because the editors, possibly unfashionably, believe that, faced with an ever-expanding, protocol-driven, standardized medical culture, the concepts and ideas of group dynamics and counter-transference need to be rediscovered if primary care is to be effective. In sum, this book is an essential vade-mecum for all primary care men

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Editorial Reviews

Doody's Review Service
Reviewer: Daniel Loiterstein, MD (Rush University Medical Center)
Description: Much of mental health treatment is not practiced by psychiatrists or psychologists, but by primary care physicians. This book focuses on this aspect of primary care.
Purpose: This book provides those practicing within the realm of primary care with guidance about their patients who require mental health interventions. The authors recognize the importance of the relationship of the general practitioner and the patient. They describe the profound impact that general practitioners may have in mental health. The book achieves its goal of being a comprehensive resource for how mental health care can be effectively and practically dispenses in the primary care setting.
Audience: The book is targeted at professionals working the primary care setting, such as general practitioners, psychiatrists, psychologist, nurses, counselors, and psychotherapists. The authors focus on a team of professionals treating mental health patients in the primary care setting. The chapter authors are credible authorities in their disciplines. The editors include both a psychotherapist and a general practitioner, both well regarded in their fields.
Features: The book is split into four distinct sections. The first sections focus on the encounter of a psychiatric patient in a primary care setting. The second identifies many of the problems involved in treating this challenging population. The third section involves professionals other than the physician and it describes the members of a multidisciplinary team. Section four discusses particular topics in psychiatry relevant to primary care. Although the book is comprehensive, it focuses on the system currently in place in the U.K. Practitioners form other countries may not find the book very applicable.
Assessment: This is a comprehensive and unique addition to the literature. It highlights the steady but uneasy relationship between psychiatry and primary care. It is a useful book for all involved in the either field, but those outside of the U.K. may find the book limited.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780198508946
  • Publisher: Oxford University Press, USA
  • Publication date: 11/28/2002
  • Series: Oxford General Practice Series
  • Pages: 334
  • Product dimensions: 6.00 (w) x 9.10 (h) x 0.90 (d)

Meet the Author

The Tavistock and Portman NHS Trust, London

University of Exeter

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Table of Contents

List of contributors
Introduction: The Need for a New Approach 1
Pt. I In the consulting room
1 In the consulting room 11
2 Body and mind 27
3 Biological and narrative time in clinical practice 45
4 Mental illness, general practice, and society 55
Pt. II Reflective practice
5 The difficult patient 71
6 Stress, strain, and burnout: support and supervision 89
7 Training for GPs 105
Pt. III Mental health thinking in the surgery
8 The practice as an organization 121
9 Systemic family practice in primary care 135
10 Therapists and counsellors in primary care 147
Pt. IV Perspectives from secondary care
11 Postnatal depression 167
12 Eating disorders 179
13 Management of serious mental illness 189
14 Suicide, deliberate self-harm, and severe depressive illness 209
15 Substance misuse 221
16 Psychopharmacology 241
17 Trauma and post-traumatic stress disorder 259
18 Psychological therapies 275
References 285
Index 313
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