A CHALLENGE FOR COMMUNITY PSYCHIATRIC NURSING - IS THERE A FUTURE IN PRIMARY HEALTH-CARE

The growing debate surrounding the role of the community psychiatric n urse (CPN) in the United Kingdom is reviewed. Issues which have attrac ted significant interest and which form the focus of this paper are th e prioritization of CPN services, CPN attachment to primary health car e (PHC), and the effectiveness of clinical interventions. The requirem ent for CPNs is now to concentrate services on people experiencing sev ere and enduring mental health problems. Innovative and effective clin ical and social interventions for this client group are beginning to d isseminate into everyday CPN practice. Problem-solving family interven tions, cognitive therapies and case management are three such examples . The past, present and possible future role for CPNs working in prima ry health care settings with people experiencing nonpsychotic mental h ealth problems is a particular focus in this paper. Drawing on the rel evant literature, central issues addressed are the process and outcome of CPN work with nonpsychotic service users, reasons for the growth o f CPN involvement in PHC, and the overall expansion of interest in men tal health interventions within the primary health care environment. T he literature suggests that this expansion has been strategically unpl anned, but that mental health need amongst primary health care service users is significant. The concluding contention of this pap er is tha t a future role for CPNs in primary care does exist.