The Trust as worked with local Primary Care Networks to introduce and support the first contact mental health practitioners, which have been working into GP surgeries since 2021. Recent figures show, based on an average of 1,921 patients over a three-month period*, 92% of patients were supported directly. Only 5% needed to be seen by a GP and 3% required a referral to specialist secondary mental health services.
How the roles came about
The practitioners have been introduced as part of a programme called Community Mental Health Transformation. It’s a key programme of work across our Trust, which aims to change the way people are supported in their local communities.
One of the first steps in the programme was to improve early access to support and to reduce unnecessary referrals to secondary mental health services. This was to ensure people got the right support, first time. First contact mental health workers have played an integral role in this. 40 now work into a wide range of GP surgeries across North Yorkshire and York. There are plans for more by the end of the year.
Transforming how people are supported
David Kerr Community Mental Health Transformation and programme delivery lead, North Yorkshire and York Mental Health Alliance said: “The introduction of first contact mental health practitioners really is transforming the way people are being supported. Prior to the roles being introduced most people were referred to secondary mental health services. People often waited a considerable time to be seen due to the high demand for support. A significant number were then passed back to primary care as they didn’t require the specialist intervention. By which time some people’s mental health had deteriorated further.
“Now only a small number of people need referring or even passing on to their GP. Most people are being supported in other ways in their local communities. This means they’re getting the help they need more quickly.”
What first contact mental health practitioners do
First contact mental health practitioners are specialists in mental health and work directly into GP surgeries. They can provide quick assessments, offering 1:1 support. They also help people to access local services that can help their wellbeing.
Laura Wright, team manager, Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) oversees the first contact mental health practitioners in North Yorkshire and York. She said: “The practitioners have been a fantastic addition. They’re so passionate about helping local people and we’ve received great feedback from patients and colleagues. People have commented on the benefits of not having to retell their story. Instead, they have time to explore their needs during their appointment.
“The team’s finding innovative new ways to expand their knowledge so that they can support people further. They’ve undertaken LGBTQ and bereavement training, become Cancer Champions, and are actively involved in a ‘nature prescription’ trial too.”
Emma Keating, Business Manager, Mowbray Square Primary Care Network, Harrogate has first contact mental health practitioners working with her team. She comments: “The new roles are a real asset. By having the practitioners in the practice, patients with mental health issues are getting to see the most appropriate clinician in a timely way and offered the support that’s right for them.”
Working collaboratively and holistically
To ensure a holistic approach, first contact mental health practitioners work closely with other public and community organisations to address people’s wider social, physical, environmental and economic needs.
Laura adds: “I’m so proud of what they’ve achieved. They’ve great relationships with local groups and organisations. They work closely with them to ensure people get the support they need. This might often go beyond standard health and wellbeing support. It could include housing, benefit or employment advice, as well as attending local wellbeing fairs, and being present in the community.”
What our Primary Care colleagues think
Dr Richard James, Clinical Director, Richmondshire Primary Care Network comments: “Having a first contact mental health practitioner in our practice has been a game changer. Mental health forms a large proportion of GP work and the consultations tend to be longer than normal. Having these practitioners has had a significant impact on our workload as well as improving the care of our patients. We really value all they do.”
The first contact mental health practitioners also support multi-disciplinary meetings. These meetings allow staff from different organisations to come together to discuss patients’ needs and care. It allows professionals to look at the varied approaches and options available in supporting or treating them. The meetings also reduce the need for patients having to meet separately with different services, repeating their stories or being placed on further waiting lists.
Heather Selby, Digital and Transformation Manager, Whitby Coast and Moors Primary Care Network also has practitioners working alongside her team. She said: “We’re really happy to have these practitioners working with us. They’ve a real drive to deliver the best possible mental health provision across Whitby and have been a huge source of support for both staff and patients.”
Dr Daniel Kimberling, GP Partner, Haxby Group Practice, York has worked with TEWV to introduce the roles in their surgeries. He adds: “Mental health matters just as much as physical health. These practitioners have provide more options for people who are struggling with their mental health. They’ve also strengthened our link with the community mental health teams and psychiatrists to try to get together to support people when their mental health needs help.
Improving and sharing knowledge
The new roles have not only reduced the number of mental health related appointments for GPs, freeing them up to see more patients, but the close partnership working has helped to improve the knowledge that GPs and wider primary care staff have about mental health. It’s encouraged a more joined up approach to how people are supported.
Joanne McElwee, Practice Manager, Stokesley Surgery adds: “The approach has shared our workload and freed up GP appointments, as low/medium level mental health presentations are such a prevalent reason for people to need a timely appointment. Having a dedicated mental health worker has allowed patients to receive timely support and signposting and support to access relevant service, which they (and likely us a GPs) may not have known existed.
Lisa’s story
As a single mum, on a low income and living in a rural area of North Yorkshire Lisa found life very difficult at times. She had always struggled with her mental health and as her daughter approached high school age Lisa’s anxiety got the better of her and she knew she needed to seek support.
She was initially apprehensive about going to her GP as she found it difficult to talk about her mental health. However, after finding out about the new First Contact Mental Health Workers, Lisa decided to take the step she needed towards support and met with Sophie one of the first contact mental health workers.
Lisa said: “Discovering the wonderful support from Sophie was life changing maybe even lifesaving. She helped me face, accept and deal with all my anxiety. It was like having the lights switched on again after years of being in the darkness.”
Despite having the support of her friends and family, Lisa hadn’t realised just how much she was dealing with things on her own.
Lisa adds: “When I first met Sophie, she looked me in the eyes and she said, ‘we can sort this out’. She made it all sound very simple and doable. From that day, I have had started to have feelings of hope and a belief that I will find much better ways for me to cope with my life.”
Lisa had resigned herself to a specific way of life, but Sophie showed her it didn’t need to be that way. Lisa comments: “As an older parent in my 50’s, I am feeling a new lease of life. Sophie has helped me to think about how I could be a successful working woman again and not be on benefits low income forever. This is the most important change to my mental outlook. I have started to believe in myself again.
“My Department for Work and Pension work coach has noticed a big difference in my outlook too and without sound too daft, things in the garden are really much rosier. I feel like my life is restarting after years of being stuck in first gear.”
Lisa strongly supports the first contact mental health workers and believes they are essential. She said: “I’m totally convinced that first contact mental health workers are the way to go in the future. Sophie was very caring, and her knowledge and skills helped to see through to my inner most issues in need of fixing. She’s not only greatly enhanced the quality of my life but also the life of my daughter. I will be forever grateful for the help I have been given.”
Find out more about the North Yorkshire and York Community Mental Health Transformation programme.
