1. GP & primary care
education & awareness in
youth mental health: the
CWMT GP toolkit
Dr Maryanne Freer Maryanne.freer@pcpartners.org
Dr David Shiers david.shiers@iris-initiative.org.uk

2. Introductions- ourselves
I

4. ‘In the varied topography of
professional practice, there is a
high, hard ground of technical
rationality which overlooks a
swamp where problems are messy,
confusing and incapable of
technical solution.

5. The difficulty is that the problems of
the high ground, however great their
technical interest, are often relatively
unimportant to clients or to the larger
society, while in the swamp are the
problems of the greatest human
concern’
Donald Schon - Bostonian MIT 1984

6. In the swamp...
people have needs
and problems
…….before they have diagnoses

7. In the swampy world of primary care...
The GP and School Nurse are two
of the most favoured health staff
by young people
In 1 of 3 teenage consultations
with the GP the young person has a
diagnosable mental health problem
Young people present to the GP
with minor physical health
presentations often brought in by a
parent
Primary can offer continuity &
longitudinal care

8. Generalist practice is …
“decision-making which is
person-, not disease-focused,
which is continuous and not
episodic, which integrates the
biographical and the
biotechnical knowledge … all
with a view to supporting health
as a resource for living and not
an end in itself.”
Joanne Reeve, NIHR Clinical
Scientist in Primary Care,
University of Liverpool

9. The GP service & consultation unpicked
For a young person…
what is unique about the GP service?

10. For a young
person…
what is unique
about the GP
service?

11.  NO ELIGIBILITY CRITERIA / YOU DON’T
NEED A DIAGNOSIS / NO TRANSITIONS
Unique…
 Access to help through routes that
young people already use LOCALLY
 Use of physical health to engage young
person
 Longitudinal care from early childhood
onwards – episodic care
 Early detection & intervention with
other family members.
 Early medical risk assessment
 GP commissioning

12. Youth mental health services- don't forget the GP!
(and GP commssioners – don’t forget youth
mental health)
 CWMT GP toolkit. www.cwmt.org.uk
RCGP Endorsed
Ways to engage
Ways to support
- GP case studies
- GP & team consultation tools

13. Working with parents
Dr Maryanne Freer www.cwmt.org
maryanne.freer@pcpartners.org

14. ...consent and confidentiality
Dr Maryanne Freer www.cwmt.org
maryanne.freer@pcpartners.org

15. Early detection & assessment
Mental health consultation framework
Life Situation
Altered thinking (ICE)
Altered physical Altered emotional
symptoms feelings
Altered behaviour

16. Early prevention – self care

17. Early prevention –problem solving

18. Early prevention – Health ( mental) promotion

19. CWMT training available
• Train the trainers:
- For people with a training and
partnership role
- Ways to engage, partner & train primary
care in young people mental health
• One off, local, primary care training in
young people mental health
- to get the ball rolling
- to get others involved & support further
partnership working

20. v

21. The last word – Jack