8 Mental Ill Health in Primary Care

Mental ill health is common. However, whilst the risk of developing any disorder is high, the type and severity of disorder varies. Most mental health is mild and self-limiting, a significant proportion is chronic and causes moderate disability and a small proportion of people suffer life-long, severely disabling illness. Whatever the type and severity, the majority of mental ill health seen by health services initially presents to, and is managed by, primary care practitioners. Mental health policy has, until recently, focused heavily on the need to provide a range of services for those with the most severe mental illness. However, the National Service Framework for Mental Health makes primary mental health care of central importance by setting two standards that relate directly to the delivery of mental health care by primary care practitioners. There is also a requirement to develop local referral protocols and for mental health promotion to be implemented. In addition, The NHS Planmakes reference to primary care mental health by creating new graduate primary care mental health workers. The effect of mental ill health on the individual, their relatives and society is profound. For the individual it can affect quality of life, the ability to work and maintain social relationships and even to live an independent life. Mental illness also makes a significant contribution to premature mortality. For families and carers, mental ill health can be a significant burden. For society, the cost of mental ill health is significant as is its impact on employment.