title: Improving access to primary mental health services: are link workers the answer?
abstract: Background The incidences of common mental disorders such as anxiety, depression and low-level post-traumatic stress are associated with deprivation. Since 2007, the Improving Access to Psychological Therapy (IAPT) programme in Ealing has made it easier for primary care practitioners to refer patients with common mental disorders for treatment. However, fewer patients of a black and minority ethnic (BME) background were referred than expected. Setting Southall, Ealing, is a diverse ethnic community; over 70% of the population is classified as having a BME background. Aim To evaluate the effect of locating mental health link workers in general practitioners' (GP) surgeries on referral of BME patients to IAPT services. Methods In 2009, an initiative in Southall helped practitioners and managers that served geographic areas to work with many different agencies to improve whole systems of care. One strand of this work led to mental health link workers being placed in 6 of the 23 GP practices. They provided psychological therapy and raised awareness of common mental disorders in BME groups and what mental health services can do to improve these. Referrals to the service were monitored and assessed using statistical process control. Results The mean referral rate of BME patients for GP practices without a link worker was 0.35 per week per 10 000 patients and was unchanged throughout the period of the study. The referral rates for the six practices with a link worker increased from 0.65 to 1.37 referrals per week per 10 000 patients. Conclusions Link workers located in GP practices, as part of a collaborative network of healthcare, show promise as one way to improve the care of patients with anxiety and depression from BME communities.
authors.affiliation: Quality Improvement Project Manager and Fellow.
authors.forename: Liz
authors.initials: L
authors.lastname: Evans
authors.affiliation: Public Health Research Fellow NIHR CLAHRC for Northwest London, Imperial College London, London, UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Green
authors.affiliation: Black and Minority Ethnic IAPT Lead.
authors.forename: Kiran
authors.initials: K
authors.lastname: Sharma
authors.affiliation: Community Development Worker Mental Health and Wellbeing Service, West London Mental Health Trust, London, UK.
authors.forename: Fatima
authors.initials: F
authors.lastname: Marinho
authors.affiliation: Clinical Lead Editor, London Journal of Primary Care ; Ealing Clinical Commissioning Group, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Thomas
keywords: black and minority ethnic groups; community mental health services; integrated care; link workers; participation; primary care; quality improvement