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Status of primary and secondary mental health care of people with severe mental illness : an epidemiological study from the UK PARTNERS2 study
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Reilly, Siobhan, McCabe, Catherine, Marchevsky, Natalie, Green, Maria, Davies, Linda, Ives, Natalie, Plappert, Humera, Allard, Jon, Rawcliffe, Tim, Gibson, John, Clark, Michael, Pinfold, Vanessa, Gask, Linda, Huxley, Peter, Byng, Richard and Birchwood, Max (2021) Status of primary and secondary mental health care of people with severe mental illness : an epidemiological study from the UK PARTNERS2 study. BJPsych Open, 7 (2). e53. doi:10.1192/bjo.2021.10 ISSN 2056-4724.
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Official URL: https://doi.org/10.1192/bjo.2021.10
Abstract
Background
There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness.
Aims
This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK.
Method
We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages.
Results
The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years.
Conclusions
The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Primary care (Medicine) -- Great Britain, Public health -- Great Britain, Mental health services -- Great Britain, Mental illness, Mental illness -- Treatment, Dangerously mentally ill -- Care -- Great Britain, People with mental disabilities -- Care -- Great Britain | ||||||||
| Journal or Publication Title: | BJPsych Open | ||||||||
| Publisher: | Royal College of Psychiatrists | ||||||||
| ISSN: | 2056-4724 | ||||||||
| Official Date: | March 2021 | ||||||||
| Dates: |
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| Volume: | 7 | ||||||||
| Number: | 2 | ||||||||
| Article Number: | e53 | ||||||||
| DOI: | 10.1192/bjo.2021.10 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Copyright Holders: | © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists | ||||||||
| Date of first compliant deposit: | 20 January 2021 | ||||||||
| Date of first compliant Open Access: | 17 February 2021 | ||||||||
| RIOXX Funder/Project Grant: |
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