In Lancashire we are working on a National Institute of Health Research (NIHR), Research for Patient Benefit (RfPB) funded Randomised Control Trial (RCT), known as ‘The Mental Health Prevention and Promotion Study in General Practice settings: A Feasibility Study’, or The MEND Study for short.
The MEND Study is seeking to evaluate the feasibility of recruiting General Practice patients into a randomised study where they will receive either treatment as usual or a brief psychological intervention for preventing the deterioration of mental health. We are funded March 2023- October 2024 and hope to build up to a subsequent larger trial that would evaluate the clinical and cost-effectiveness of the intervention. We want to learn about helping people early- before they experience more distress.
We are writing this blog in an attempt to generate interest about this important topic and reach out to anyone who is potentially already working in this area, or interested in being part of the next stage, the larger bid. If you are interested, or want to hear more then please do get in touch!
Mental health care is a core part of the business in General Practice, with reportedly 90% of all mental health care being delivered in primary care. 81% of people seeking mental health support start their journey by making an appointment to see their GP, perhaps they’ve been worrying about it for a while, perhaps a loved one managed to persuade them to go and talk to their Doctor. Either way, primary care is a great place to engage in a preventative approach because of the contact GP surgeries have with the local community, the non-stigmatizing nature of the service, ease of access and the frequency with which mental health need presents (reportedly part of 1 in 3 appointments).
The opportunities to intervene early, to help reduce distress, reduce demand on services and increase GP capacity are exciting. As General Practice expands to meet the ambitions of the NHS Long Term Plan, to provide more care in the community, additional roles are joining the expanding workforce. In most places this includes the addition of Mental Health Practitioners (MHPs). MHP is an umbrella term for a number of qualified professionals who are able to provide mental health care. One challenge arises in the support a clinician would need to be able to adopt a more proactive, as opposed to reactive approach. When demand is high, it can be a clinical challenge to protect time to prevent, to work with those who may be vulnerable, but ultimately could wait to be ‘tomorrow’s problem’. Another issue is what exactly is a preventative intervention? There is research evidence available, but it is still a growing area and one to strengthen.
Multiple partners will need to come together to have the best impact. Not all interventions that impact upon mental health happen in a clinic room. Opportunities for social engagement, fresh air, good quality housing and food all have significant impacts upon people’s mental health. All pieces of the jigsaw puzzle need to come together to complete the picture and increase resiliency on both an individual and community level. However, an important part of that jigsaw puzzle is having the understanding and skills to manage emotional distress. Of course, part of being human is to experience feelings, however, what varies is people’s knowledge about ability to tolerate or cope with the emotional responses they may have to different situations. Teaching people basic psychological skills as part of a brief psychological intervention can help prevent distress and promote positive emotional wellbeing.
Interested in being part of the next bid? What to hear more? Please contact us at-
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