Evans Liz, Green Stuart, Sharma Kiran, Marinho Fatima, Thomas Paul
Quality Improvement Project Manager and Fellow.
Public Health Research Fellow NIHR CLAHRC for Northwest London, Imperial College London, London, UK.
London J Prim Care (Abingdon). 2014;6(2):23-8. doi: 10.1080/17571472.2014.11493409.
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.
焦虑、抑郁和轻度创伤后应激障碍等常见精神障碍的发病率与贫困相关。自2007年以来，伊灵区的改善心理治疗可及性（IAPT）项目使初级保健从业者更容易将患有常见精神障碍的患者转诊接受治疗。然而，转诊的黑人和少数族裔（BME）背景患者比预期少。地点：伊灵区的索撒尔是一个多民族社区；超过70%的人口被归类为具有BME背景。目的：评估在全科医生（GP）诊所安排心理健康联络人员对将BME患者转诊至IAPT服务的影响。方法：2009年，索撒尔的一项倡议帮助服务于特定地理区域的从业者和管理人员与许多不同机构合作，以改善整个护理系统。这项工作的一个方面是在23家GP诊所中的6家安排了心理健康联络人员。他们提供心理治疗，并提高BME群体对常见精神障碍以及心理健康服务可以如何改善这些问题的认识。使用统计过程控制对该服务的转诊情况进行监测和评估。结果：没有联络人员的GP诊所中，BME患者的平均转诊率为每10000名患者每周0.35例，在研究期间保持不变。有联络人员的6家诊所的转诊率从每10000名患者每周0.65例增加到1.37例。结论：作为医疗保健协作网络的一部分，在GP诊所安排联络人员有望成为改善BME社区焦虑和抑郁患者护理的一种方式。
