DISTRIBUTION OF MENTAL-HEALTH PROFESSIONALS WORKING ON SITE IN ENGLISH AND WELSH GENERAL PRACTICES

Objective-To describe the nature and distribution of mental health pro fessionals working on site in general practices. Design-Postal questio nnaire and telephone interview survey. Setting-English and Welsh gener al practices. Subjects-1880 general practitioners, of whom 1542 (82%) responded. Main outcome measures-Prevalence, types, and distribution o f mental health professionals working on site among general practices. Factors predicting the presence of mental health professionals on sit e. Results-The number of practices reporting the presence on site of e ach type of professional were 528 for community psychiatric nurses; 26 6 for practice counsellors; 177 for clinical psychologists; 132 for ps ychiatrists; 96 for psychiatric social workers; and 45 for psychothera pists. Mental health professionals tended to cluster together in pract ices more often than expected by chance alone. Practice characteristic s which independently predicted the presence of a mental health profes sional on site were having four or more partners; being a training pra ctice; and running stress, bereavement, or other mental health clinics . The proportions of practices with mental health professionals on sit e varied significantly among health regions. There was no association between the presence of mental health professionals on site and the lo cation of practices, the social class mix of patients, or the estimate d percentage of elderly patients or patients of non-European origin. C onclusions-Mental health professionals tend to cluster together, with a preponderance in larger training practices. Specialist mental health care provision within general practices is unevenly distributed. Furt her research is needed to determine whether this uneven distribution r eflects differences in need or inequalities in the provision of mental health services.