Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation.
BACKGROUND
Patients with psychosocial problems may benefit from a variety of community, educational, recreational and voluntary sector resources, but GPs often under-refer to these through lack of knowledge and time. This study evaluated the acceptability and effectiveness of graduate primary care mental health workers (GPCMHWs) facilitating access to voluntary and community sector services for patients with psychosocial problems.


METHODS
Patients with psychosocial problems from 13 general practices in London were referred to a GPCMHW Community Link scheme providing information and support to access voluntary and community resources. Patient satisfaction, mental health and social outcomes, and use of primary care resources, were evaluated.


RESULTS
108 patients consented to take part in the study. At three-month follow-up, 63 (58%) had made contact with a community service identified as suitable for their needs. Most were satisfied with the help provided by the GPCMHW in identifying and supporting access to a suitable service. There was a reduction in the number of patients with a probable mental health problem on the GHQ-12 from 83% to 52% (difference 31% (95% CI, 17% - 44%). Social adjustment improved and frequencies of primary care consultations and of prescription of psychotropic medications were reduced.


CONCLUSIONS
Graduates with limited training in mental health and no prior knowledge of local community resources can help patients with psychosocial problems access voluntary and community services, and patients value such a scheme. There was some evidence of effectiveness in reducing psychosocial and mental health problems.
Grayer
Justin
J
Centre for Outcomes Research and Effectiveness, Sub-department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. justin.grayer@uclmail.net
Cape
John
J
Orpwood
Lisa
L
Leibowitz
Judy
J
Buszewicz
Marta
M
D000293:Adolescent; D000328:Adult; D003153:Community Health Services / Q000706:statistics & numerical data; D005194:Family Practice; D006297:Health Services Accessibility; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014837:Voluntary Health Agencies