Effective Training for GPs and Primary Care Effective Training for GPs and Primary Care Workers in Mental healthWorkers in Mental health

Dr Ian WaltonDr Ian WaltonLisa HillLisa Hill

Primary Care is different to Primary Care is different to PsychiatryPsychiatry

22

More art than scienceMore art than science Patients present with somatic symptomsPatients present with somatic symptoms The border between distress and The border between distress and

psychiatric illness is hard to definepsychiatric illness is hard to define Needs to include WellbeingNeeds to include Wellbeing Needs skills which can be used in a 10 Needs skills which can be used in a 10

minute consultationminute consultation

33

Secondary Care

Primary Care

Who deals with what?

Psychological and Physical Psychological and Physical health are linked health are linked

44

The only way to separate the mind The only way to separate the mind from the body is with an axe.from the body is with an axe.

Physical illness causes stress Physical illness causes stress Stress may result in functional Stress may result in functional

symptoms and organic alterationsymptoms and organic alterationThe mind and body are oneThe mind and body are one

The challengesThe challenges Developing the skills to deliver an Developing the skills to deliver an

integrated model for mental health in integrated model for mental health in primary care is an area lacking in primary care is an area lacking in investment within the UK. investment within the UK.

Government policies fail to focus on local Government policies fail to focus on local and individual primary care requirements and individual primary care requirements for the complexity of mental health work.for the complexity of mental health work.

Primary Care Education in Mental Primary Care Education in Mental Health and WellbeingHealth and Wellbeing

6

Our education offers an opportunity to Our education offers an opportunity to Experience specifically designed primary care Experience specifically designed primary care

focused educationfocused education Gain an awareness of the emphasis on Gain an awareness of the emphasis on

redesigning services to meet individual needsredesigning services to meet individual needs Develop skills which can be used in a 10 minute Develop skills which can be used in a 10 minute

consultationconsultation

What next……What next……

22/04/23www.primhe.ning.com7 22/04/23

CertificateIn Primary CareMental Health

Certificate in Primary Care Mental Certificate in Primary Care Mental Health and WellbeingHealth and Wellbeing

OUTCOME OUTCOME Primary Care workers feel more capable and Primary Care workers feel more capable and

confident when working with people who need confident when working with people who need support with their mental health problemssupport with their mental health problems

Aims of the course:Aims of the course: Enable and empower people to live happy, Enable and empower people to live happy,

healthy lives (service providers as well as healthy lives (service providers as well as recipients)recipients)

Develop reflective practiceDevelop reflective practice Work towards effective leadership for mental Work towards effective leadership for mental

health at local and regional levelshealth at local and regional levels Develop skills in accessing and critical Develop skills in accessing and critical

evaluating research into mental healthevaluating research into mental health Deliver evidence based and consistent high Deliver evidence based and consistent high

quality health care in line with NICE guidelines quality health care in line with NICE guidelines best practice and WHO recommendationsbest practice and WHO recommendations

Link theory and evidence to practiceLink theory and evidence to practice Be able to evaluate and measure outcomes for Be able to evaluate and measure outcomes for

clients and the serviceclients and the service Facilitate closer working with service users, Facilitate closer working with service users,

citizens and communitiescitizens and communities

Accredited Module in Primary Care Accredited Module in Primary Care Mental HealthMental Health

Earn 15 University Credits at level 3 and 50 credits for GP revalidation - Case study based course Earn 15 University Credits at level 3 and 50 credits for GP revalidation - Case study based course which includes practical skills useful in the 10 minute consultation taught by local and national experts which includes practical skills useful in the 10 minute consultation taught by local and national experts over four afternoons designed to inform you how better to use local resources.over four afternoons designed to inform you how better to use local resources.

  MODULE 1MODULE 1Introduction -values and beliefs, anxiety and disorders, Phobia, Panic disorder, Dealing with and helping patients with the Introduction -values and beliefs, anxiety and disorders, Phobia, Panic disorder, Dealing with and helping patients with the effects of distress, Wellbeing and self management of stress ,The importance of sleep, Strengths and limitations of effects of distress, Wellbeing and self management of stress ,The importance of sleep, Strengths and limitations of diagnosis and categorisation, Categorisation models (ICD 10,DSMIV,V) and practical consequences of their usesdiagnosis and categorisation, Categorisation models (ICD 10,DSMIV,V) and practical consequences of their uses

MODULE 2MODULE 2Depression, Unipolar and bipolar depression, The patient’s perspective, The carers perspective, Depression in the elderly, Depression, Unipolar and bipolar depression, The patient’s perspective, The carers perspective, Depression in the elderly, Suicide and risk, Self stigmatisation, Stepped Care Approach and “Watchful Waiting”,anti-depressant medicationSuicide and risk, Self stigmatisation, Stepped Care Approach and “Watchful Waiting”,anti-depressant medication

MODULE 3MODULE 3Psychosis, helping primary care practices to achieve QoF ,Identification and management of risk, Shared care and Psychosis, helping primary care practices to achieve QoF ,Identification and management of risk, Shared care and working more effectively with patients with complex needs, The carers perspective, working with complex needs, working more effectively with patients with complex needs, The carers perspective, working with complex needs, substance and alcohol misuse, Dual Diagnosis ,working with complex needs, substance misuse and alcoholsubstance and alcohol misuse, Dual Diagnosis ,working with complex needs, substance misuse and alcohol

MODULE 4MODULE 4Dementia, Older persons mental health needs, The carers perspective, Early onset dementias, Psychosomatic Dementia, Older persons mental health needs, The carers perspective, Early onset dementias, Psychosomatic Medicine ,Medically unexplained symptoms, Why patients attend frequently and ways to help themMedicine ,Medically unexplained symptoms, Why patients attend frequently and ways to help them

9

Advanced Diploma in Primary Care Advanced Diploma in Primary Care Mental HealthMental Health

Course outcomes: Course outcomes:

Improve the health outcomes for individuals Improve the health outcomes for individuals with mental health problems when seen in with mental health problems when seen in general practice, general practice,

Improve the recognition, diagnosis and Improve the recognition, diagnosis and treatment of patients with mental health treatment of patients with mental health problems, problems,

Develop and improve skills, knowledge and Develop and improve skills, knowledge and attitude that can be used in a ten minute attitude that can be used in a ten minute consultation with patients suffering a mental consultation with patients suffering a mental health problem and an understanding of the health problem and an understanding of the range of problems seen in primary carerange of problems seen in primary care

Contribute to the evidence base for the Contribute to the evidence base for the continuing development of mental health continuing development of mental health services.services.

‘‘I thought I understood mental health but for the I thought I understood mental health but for the first time I saw it pulled together and become first time I saw it pulled together and become meaningful’ GP meaningful’ GP

‘‘Informative, challenging and has changed my Informative, challenging and has changed my whole practice.’ GP whole practice.’ GP

Each module is designed after careful Each module is designed after careful deliberation using a range of expertise deliberation using a range of expertise at a local and national level. at a local and national level.

Module 1 Anxiety Module 1 Anxiety

Module 2 Depression Module 2 Depression

Module 3 PsychosisModule 3 Psychosis

Module 4 Dementia and medically Module 4 Dementia and medically unexplained symptomsunexplained symptoms

Module 5 Substance Misuse. Module 5 Substance Misuse. Addictions and Personality DisorderAddictions and Personality Disorder

Module 6 Children’s and Maternal Module 6 Children’s and Maternal Mental HealthMental Health

Masters Science Specialist in Primary Care Masters Science Specialist in Primary Care Mental healthMental health

Postgraduate CertificatePostgraduate CertificateLevel 7Level 7

Postgraduate DiplomaPostgraduate DiplomaLevel 7Level 7

MastersMastersLevel 7Level 7

Year 1 Year 1 Year 2 Year 2 Year 3 Year 3

Four Core Modules Four Core Modules (15 credits x 4)(15 credits x 4)Critical appraisal skills and Critical appraisal skills and research awareness.research awareness.Facts, Beliefs and ValuesFacts, Beliefs and ValuesLeading and Enabling Leading and Enabling Service Development in Service Development in Human ServicesHuman Services

Therapies, Interventions and Therapies, Interventions and

TreatmentsTreatments

Four Core ModulesFour Core Modules(15 credits x 4)(15 credits x 4)Service RedesignService RedesignMental Health Legislation and Mental Health Legislation and Ethics-Consent and Capacity.Ethics-Consent and Capacity.Common Mental Disorders: Common Mental Disorders: Recognition, Assessment and Recognition, Assessment and Management Management

Research methods and Research methods and

methodologies.methodologies.

One Core One Core ModuleModule(60 credits)(60 credits)Project Based Project Based Change.Change.OROR

Masters Masters

DissertationDissertation

Total 60 credits Total 60 credits Total 120 credits Total 120 credits Total 180 Total 180 credits credits

Evaluation using the four levels of Evaluation using the four levels of Kirkpatrick’s modelKirkpatrick’s model

A meaningful evaluation of the learning via a steering group A meaningful evaluation of the learning via a steering group

Level one: Level one: Happy sheets ‘are completed following individual speakers and feedback forms Happy sheets ‘are completed following individual speakers and feedback forms gather subjective personal reactions to the learning experience. The learning sets also gather subjective personal reactions to the learning experience. The learning sets also enable individuals to discuss their feelings with their peers. We have 98% High satisfaction enable individuals to discuss their feelings with their peers. We have 98% High satisfaction rate of the trainingrate of the training

Level two:Level two: Demonstrate an increase in knowledge and intellectual capability from before to Demonstrate an increase in knowledge and intellectual capability from before to after the learning experience through reflective case studies. All of the students who have after the learning experience through reflective case studies. All of the students who have submitted have passed the Diploma.submitted have passed the Diploma.

Level threeLevel three: Examines the extent of the learned behaviour and the capability for personal : Examines the extent of the learned behaviour and the capability for personal improvement and the implementation or application of what they have learned. This is improvement and the implementation or application of what they have learned. This is scoped through reflective practice during the programme. scoped through reflective practice during the programme.

Level four:Level four: Finally the overall results are evaluated and disseminated to demonstrate the Finally the overall results are evaluated and disseminated to demonstrate the effects on primary care through the performance and outputs of the primary care mental effects on primary care through the performance and outputs of the primary care mental health workers. health workers.

The course provides primary care workers with 50 credits, equivalent to a whole years The course provides primary care workers with 50 credits, equivalent to a whole years revalidation. A course handbook lets applicants clearly see the learning outcomes desired revalidation. A course handbook lets applicants clearly see the learning outcomes desired from them. from them.

Level Four OUTCOMESLevel Four OUTCOMES It is evidenced that practices attending the training It is evidenced that practices attending the training

use less secondary care resources and are smarter use less secondary care resources and are smarter at referringat referring

Staff are able to integrate pathways and share Staff are able to integrate pathways and share valuesvalues

GP practices are able to hit their targets (QOF)GP practices are able to hit their targets (QOF) Patients have a better experience and there is a Patients have a better experience and there is a

smooth transition from secondary to primary caresmooth transition from secondary to primary care Increased confidence in dealing with suicidality and Increased confidence in dealing with suicidality and

risk within primary care.risk within primary care.

Further InformationFurther Information

llisa.hill9@btinternet.comianwalton@btinternet.com

www.primhe.org.ukwww.primhe.org.uk