London's mental health services are improving but funding and recruitment problems remain, says The King's Fund report

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Mental health services in primary care in London are being hampered due to a lack of funding and severe problems with recruiting and retaining skilled workers, says a new King's Fund report.

Mental Health Services in Primary Care, by Rebecca Rosen and Clare Jenkins, surveyed one in five GP practices in London and the mental health leads in London's primary care trusts (PCTs). It found that 42 per cent of family doctors believe mental health services in primary care in the capital have improved over the last three to five years, while almost a third said they had deteriorated.

More than 80 per cent of people with mental health problems are treated in general practice and never need more specialist help. Despite this, family doctors responding to the survey said they face problems providing good quality services due to lack of funding, high staff turnover and ongoing organisational change in PCTs.

The report, which comes almost six years after The King's Fund Inquiry into London's mental health in 1997, also revealed that 80 per cent of all responding practices had access to counsellors in their own or a neighbouring practice.

Report author Rebecca Rosen said:

'There is evidence of some improvement in the overall quality of mental health services since The King's Fund's last Inquiry, but these improvements are not happening in all areas of London.

'The problem is that PCTs lack funding to develop mental health services so they tend to focus too much on people with severe mental illness, rather than on primary care mental health. The majority of family doctors who took part in the survey also raised concerns that people who are particularly vulnerable to mental health problems, such as homeless people, those with addictions and some asylum seekers, were not receiving adequate support.'

Mental Health Services in Primary Care, which focuses on general practice-based services for people with common mental health problems and the role of PCTs in developing them, recommends that:

  • More funds should be made available at a national level for mental health services
  • All PCTs should identify a budget for mental health services and that primary mental health care should feature in the top two or three priorities identified in every PCT
  • PCTs should improve their capacity to commission mental health care. For many PCTs, this will require a development budget, increased numbers of commissioning staff and better systems for integrating diverse activities relating to mental health service
  • A primary care mental health champion is appointed in each PCT to lead developments in general practice. This post will need to be funded for several sessions per week if it is to have real impact on primary care services.

Notes to editors

Mental Health Services in Primary Care: A review of recent developments in London, is by Rebecca Rosen and Clare Jenkins.

The report is one of a series of papers being produced in 2003 as part of The King's Fund Mental Health Inquiry. The Inquiry aims to assess whether London mental health and mental health services have improved over the last five years. In 1997 The King's Fund produced a report entitled London's Mental Health, describing services in inner London 'that cannot be sustained'. The current Inquiry asks what, if anything, has changed since then, as well as tackling some new questions. The findings will be published in July.

For review copies or interviews with the author, please contact Daniel Reynolds on 020 7307 2581 or 07831 554927.