Dr David Shiers & Dr Maryanne Freer - Youth Mental Health in Primary Care

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Dr David Shiers & Dr Maryanne Freer - Youth Mental Health in Primary Care

  1. 1. GP & primary care education & awareness in youth mental health: the CWMT GP toolkitDr Maryanne Freer Maryanne.freer@pcpartners.orgDr David Shiers david.shiers@iris-initiative.org.uk
  2. 2. Introductions- ourselvesI
  3. 3. ‘In the varied topography ofprofessional practice, there is ahigh, hard ground of technicalrationality which overlooks aswamp where problems are messy,confusing and incapable oftechnical solution.
  4. 4. The difficulty is that the problems ofthe high ground, however great theirtechnical interest, are often relativelyunimportant to clients or to the largersociety, while in the swamp are theproblems of the greatest humanconcern’ Donald Schon - Bostonian MIT 1984
  5. 5. In the swamp...people have needsand problems…….before they have diagnoses
  6. 6. In the swampy world of primary care... The GP and School Nurse are two of the most favoured health staff by young people In 1 of 3 teenage consultations with the GP the young person has a diagnosable mental health problem Young people present to the GP with minor physical health presentations often brought in by a parent Primary can offer continuity & longitudinal care
  7. 7. Generalist practice is …“decision-making which is person-, not disease-focused, which is continuous and not episodic, which integrates the biographical and the biotechnical knowledge … all with a view to supporting health as a resource for living and not an end in itself.” Joanne Reeve, NIHR Clinical Scientist in Primary Care, University of Liverpool
  8. 8. The GP service & consultation unpickedFor a young person…what is unique about the GP service?
  9. 9. For a youngperson…what is uniqueabout the GPservice?
  10. 10.  NO ELIGIBILITY CRITERIA / YOU DON’T NEED A DIAGNOSIS / NO TRANSITIONSUnique…  Access to help through routes that young people already use LOCALLY  Use of physical health to engage young person  Longitudinal care from early childhood onwards – episodic care  Early detection & intervention with other family members.  Early medical risk assessment  GP commissioning
  11. 11. Youth mental health services- dont forget the GP! (and GP commssioners – don’t forget youth mental health)  CWMT GP toolkit. www.cwmt.org.uk RCGP Endorsed Ways to engage Ways to support - GP case studies - GP & team consultation tools
  12. 12. Working with parentsDr Maryanne Freer www.cwmt.orgmaryanne.freer@pcpartners.org
  13. 13. ...consent and confidentialityDr Maryanne Freer www.cwmt.orgmaryanne.freer@pcpartners.org
  14. 14. Early detection & assessmentMental health consultation framework Life Situation Altered thinking (ICE) Altered physical Altered emotional symptoms feelings Altered behaviour
  15. 15. Early prevention – self care
  16. 16. Early prevention –problem solving
  17. 17. Early prevention – Health ( mental) promotion
  18. 18. CWMT training available • Train the trainers: - For people with a training and partnership role - Ways to engage, partner & train primary care in young people mental health • One off, local, primary care training in young people mental health - to get the ball rolling - to get others involved & support further partnership working
  19. 19. v
  20. 20. The last word – Jack

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