Management of patients with physical and psychological problems in primary care (joint report between the Royal College of Psychiatrists and the Royal College of General Practitioners)

This report aims to highlight the importance of improving the management of individuals with both physical and psychological problems in primary care. Depression and anxiety are common in physical illness, yet mental health services are separated from physical health services with separate commissioning processes, targets and service boundaries.

As commissioning arrangements in England change, this report takes the opportunity to contribute to the provision of needs-led integrated services for people with both comorbid physical and mental health needs, as these individuals often fall through the funding gap between physical and mental health commissioners.

Most liaison psychiatry has traditionally been hospital-based, but as health services in England change, with more individuals receiving their treatment in primary care, liaison services can provide valuable support to general practitioners (GPs) and Tier 2 services, in addition to acute hospital work.

A GP is usually the first health professional to whom people turn when they develop symptoms. The report has been written as a practical guide to improve the detection and management of psychological issues and problems in the context of diagnosing and managing physical illness in the primary care setting. It is jargon-free, yet full of useful professional guidance and advice, with twelve overall recommendations and five action points; GP registrars and trainee psychiatrists should find it helpful.

The report is divided into three sections: person, process and practitioner. In all three, ‘patient-centred bio-psychosocial model’ of care is presented – it tries to move away from a mind/body dichotomy and present an approach based on successful clinical practice, supported by a strong body of research.