TY - JOUR
KW - Adolescent
KW - Adolescent Health Services/organization & administration
KW - Attitude of Health Personnel
KW - Child
KW - Child Health Services/organization & administration
KW - Child, Preschool
KW - Community Mental Health Services/manpower/organization & administration
KW - Delivery of Health Care/standards
KW - Great Britain
KW - Humans
KW - Interprofessional Relations
KW - Primary Health Care/manpower/organization & administration
KW - Referral and Consultation
AU - W. Macdonald
AU - S. Bradley
AU - P. Bower
AU - T. Kramer
AU - B. Sibbald
AU - E. Garralda
AU - R. Harrington
A1 - 
AB - BACKGROUND: The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role. AIMS: The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England. METHODS: Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services). FINDINGS: The study identified three models of organization (outreach, primary care-based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation-liaison) were common across all sites. CONCLUSIONS: The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long-term perspective on service development.
BT - Journal of advanced nursing
C5 - Education & Workforce
CP - 1
CY - England
DO - 10.1111/j.1365-2648.2003.02967.x
IS - 1
JF - Journal of advanced nursing
N2 - BACKGROUND: The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role. AIMS: The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England. METHODS: Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services). FINDINGS: The study identified three models of organization (outreach, primary care-based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation-liaison) were common across all sites. CONCLUSIONS: The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long-term perspective on service development.
PP - England
PY - 2004
SN - 0309-2402; 0309-2402
SP - 78
EP - 87
EP - 
T1 - Primary mental health workers in child and adolescent mental health services
T2 - Journal of advanced nursing
TI - Primary mental health workers in child and adolescent mental health services
U1 - Education & Workforce
U2 - 15030444
U3 - 10.1111/j.1365-2648.2003.02967.x
VL - 46
VO - 0309-2402; 0309-2402
Y1 - 2004
ER -