ABSTRACT
Primary health care is in a unique position. It is often the first point of contact between patients and health services, and it offers continuity of care and coordinates a patient’s care (Horton, 1999). In the UK, primary care now consists of multidisciplinary teams. Teams often consist of the general practitioner (GP) together with practice nurses, health visitors, occupational therapists, social workers, counsellors, psychologists and dietitians. More recently, there are also graduate mental health workers, gateway workers and ‘star’ workers. Increasingly, service users are playing an important role. In England, Primary Care Trusts (PCTs) are responsible for overseeing and funding the provision of care, and are also responsible for purchasing secondary care services. In considering influences on primary care practice, we will discuss serious mental illness, depression and the role of education in the primary care setting, and consider why there have been changes in the primary care management of people suffering from severe mental illness but little change in the management of those suffering from depression.
