Interesting day today, discussing and considering how primary care services could and probably will care for people we consider labelled as having "serious mental illness"(SMI). In other words the psychoses such as Schizophrenia and Bi-Polar disorder. Why Diabetes in the header to this entry? Well not so long ago people with diabetes would attend diabetic clinics in hospitals, spend times in waiting areas and have their blood sugars measured and their insulin levels titrated. Something that a GP or Practice nurse was not considered competent to do. Then a change occurred and the staff in Primary care were trained up (or developed competencies if you prefer) and the ongoing care of people with diabetes was transferred to primary care. No more trips to hospitals, and only probably going there at all if matters became outwith the scope of primary care.
Now could the same occur for people with SMI? Could their routine care be in the primary care setting, could this be achieved with the presence of existing secondary mental health staff located in primary care for support of their colleagues? Consider the gains. no more attending out patient clinics in possibly stigmatising settings, no more six monthly appointments where you see a different person each time, and possibly the chance to address the issue of poor physical health which still blights the lives of these clients.
Could it happen?
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