Practice nurses' perceptions of services for clients with psychological problems in primary care

Over a third of people presenting in primary care in the United Kingdom (UK ) have a mental health problem causing some degree of disruption in their l ives. Approximately 90% of these are treated and managed by primary care st aff without any support from mental health services. Following the White Pa per published by the UK Department of Health in 1997 (Department of Health, 1997. The New NHS - Modern and Dependable, HMSO, London), the influence of primary care both in the commissioning and provision of mental health serv ices is likely to increase. By far the largest professional group currently involved in mental health in primary care are practice nurses. Although th eir numbers have increased dramatically during this decade, little is known of the work they do or of their perceptions of it. The present questionnai re-based study sought to elicit the types of mental health problems encount ered by practice nurses in primary care, the interventions they provide and the skills they utilise. The data indicates that practice nurses care for people with a wide variety of mental health problems ranging from mild to s evere. Many feel unprepared for this type of work and are reluctant to get too involved with clients in case they uncover problems they are not able t o cope with. Lack of access to appropriate educational support is identifie d as the main problem currently faced by practice nurses alongside poor int er-professional relationships with mental health personnel. This paper disc usses ways of meeting the needs of practice nurses and of improving collabo ration in primary care settings. (C) 1999 Elsevier Science Ltd. All rights reserved.