Mental health in primary care, a new approach / edited by Andrew Elder and Jeremy Holmes.

Format:

Book

Contributor:

Elder, Andrew, 1945-

Holmes, Jeremy, 1943-

Language:

English

Subjects (All):

Psychiatry.

Primary care (Medicine).

Psychotherapy.

Patients--Mental health.

Patients.

Mental health.

Physical Description:

viii, 323 pages ; 24 cm

Place of Publication:

New York : Oxford University Press, 2002.

Summary:

Mental health has finally come home to primary care, where 90% of all patients with psychological difficulties are diagnosed and treated, and where Governments increasingly see the bulk of mental health commissioning and practice as belonging. This book, whose contributors include leading figures from the world of both primary care and psychiatry, brings together the best of contemporary psychiatry with a deep understanding of the realities, challenges, and opportunities of general practice. The book is divided into four parts. The reader is taken from the first-hand experience of the encounter with the psychiatric patient in the GP consulting room; through the stresses and strains of such work; to the wider primary care mental health team of counselling, family therapy, and group dynamics; and finally to specific disorders such as psychosis, eating disorders, depression, suicide, and trauma as they present in the primary care setting. The book ends with practical guidance in the use of psychotropic drugs and psychological treatments in primary care.

The tone throughout is influenced by the editors' background - one a GP the other a psychiatrist - in psychotherapy and 'Balint' groups, which places the doctor's own feelings and aspirations centre stage, no less than those of the patient. The book offers new ideas in two ways. First, in that it looks at how cutting edge psychiatry can be applied and practised in the primary care setting, away from psychiatric institutions, and adapted to the realities of primary care, where distress does not easily fit into predetermined categories derived from secondary care. Second, because the editors, possibly unfashionably, believe that, faced with an ever-expanding, protocol-driven, standardised medical culture, the concepts and ideas of group dynamics and countertransference need to be rediscovered if primary care is to be effective. In sum, this book is an essential vade-mecum for all primary care mental health workers, whether GPs, psychologists, nurses, psychiatrists, psychotherapists or counsellors. It contains practical guidance and holds onto the vision that GP, patient, family, and practice team must work together.

Contents:

Introduction: The Need for a New Approach / Andrew Elder, Jeremy Holmes 1

Part I In the consulting room

1. In the consulting room / Sam Smith 11

2. Body and mind / Richard Westcott 27

3. Biological and narrative time in clinical practice / Brian Hurwitz 45

4. Mental illness, general practice, and society / Iona Heath 55

Part II Reflective practice

5. The difficult patient / Eia Asen 71

6. Stress, strain, and burnout: support and supervision / Jane Milton 89

7. Training for GPs / Paul Sackin 105

Part III Mental health thinking in the surgery

8. The practice as an organization / John Launer 121

9. Systemic family practice in primary care / Hilary Graham, Robert Mayer 135

10. Therapists and counsellors in primary care / Mary Burd, Jan Wiener 147

Part IV Perspectives from secondary care

11. Postnatal depression / Maret Dymond, Lynne Murray, Peter J. Cooper 167

12. Eating disorders / Ulrike Schmidt 179

13. Management of serious mental illness / Christine Wright, Tom Burns 189

14. Suicide, deliberate self-harm, and severe depressive illness / Jonathan Evans 209

15. Substance misuse / Ilana Crome, Ed Day 221

16. Psychopharmacology / Adrian Feeney, David Nutt 241

17. Trauma and post-traumatic stress disorder / Gwen Adshead 259

18. Psychological therapies / Glenys Parry, John Cape 275.

Notes:

Includes bibliographical references and index.

ISBN:

0198508948

OCLC:

49942441