Partnering for better mental health

What is the background to the creation of this service?

Even before the pandemic, there was rising demand for support in the Adur and Worthing areas, and there were shortages and backlogs in existing mental health systems, particularly for people experiencing lower level mental health problems, such as anxiety and depression. So in 2019, the Adur and Worthing Primary Care Networks commissioned West Sussex Mind to provide mental health support for adults in GP surgeries.

West Sussex Mind was already well known in our local community and was running NHS-funded Pathfinder mental health support for adults in Adur and Worthing. So the primary care networks (PCNs) approached the charity and its Pathfinder partner, United Response, to co-produce and pilot a mental health social prescribing service. This would offer practical advice to help people manage their mental health and give them information about activities in the community that could benefit their mental well-being.

The social prescribing service was launched in the Adur and Worthing PCNs later that year and the feedback from patients and GPs was very positive. Mental health social prescribers in our surgeries could help people learn techniques and coping mechanisms to manage their mental health and better understand triggers that might send their mental health on a downward spiral.

The service was particularly invaluable during the pandemic. During lockdowns, support was offered by video call and on the phone and this brought a degree of flexibility which has continued post-pandemic and been a key factor in the service’s success. Indeed in-surgery mental health support, provided by third sector organisations, proved so successful in Adur and Worthing that it is being rolled out across Sussex. Soon every primary care network will have at least one mental health support coordinator to provide one-to-one sessions to people over 18 seeking help through their GP.

Who is the service most appropriate for and how does it help GP surgeries?

Now called the Emotional Wellbeing service, it is particularly helpful for people with mild to moderate mental health problems. For example, people who are suffering with depression or anxiety might not necessarily need mental health support from specialist services; often what they need is practical help and tools to help them live happier and healthier lives.

Mental health goes in cycles. You might feel very low, then you’ll feel better again, and then something might happen that sets you back. So if people start to feel that their mental health is declining, it’s important that they know what they can do to help themselves feel better and understand what might have triggered their dip in the first place.

GPs and practitioners, such as nurses and paramedics, are best placed to diagnose problems and prescribe medication if that is appropriate. But the fast-paced nature of general practice means that they are unable to offer the longer appointments that are often needed to explore someone’s mental health and to give them practical support.

It has been great to be able to offer patients an alternative, which is about building people’s resilience and understanding about their mental health and self-care. Patients can be seen by West Sussex Mind’s mental health support coordinators in the surgeries, at the charity’s Gateway support hub or people can have video calls and remote support. This means that the service is very flexible and can be tailored to people’s individual needs. We have a very close working relationship with West Sussex Mind in our GP practices, which means that we can discuss particular patients to work out what they need.

What has GP feedback been about the service?

GPs have been very supportive of the service from the outset. The nature of mental health – and the potential for periods where more support is needed – means that it’s really beneficial to be able to offer a service that gives people time to talk about their mental health and how it impacts their life, because this is hard to provide in a ten-minute GP appointment. When it is a less complex, lower level mental health problem, it helps to have practical services to equip someone to manage on a longer term basis.

GPs were getting a lot of people asking for help with their mental health before Covid, but now demand for mental health support is even greater and waiting lists are long. This can be frustrating for patients and leave them feeling like they aren’t getting the support they need. Having another avenue to suggest to patients for their mental health is invaluable. There are also Sussex Partnership NHS clinicians attached to the GP service, which means that people can get more specialist input if they need it.

GPs will be the first to admit that they don’t know everything that is available for mental health in their local community, particularly in terms of support groups and activities. So having a service like this in our surgeries relieves pressure and the demand on GPs. It’s great, because GPs feel they can offer something to patients that is of real value, and they don’t have to direct patients elsewhere, knowing that they are likely to join a long waiting list. And for patients, many of whom are attached to their GP surgery, being able to see someone in the surgery gives them comfort and trust.

There is a lot of positivity about the service among GPs and this is a real reflection of its quality and value. And at the PCN management level, it is very much a partnership approach, where we can have input into the shape and development of the service to reflect the needs of our patients and the pressures being faced in general practice.

What is the wider value of the service in terms of the community’s mental health?

The service is really successful, because it gives people experiencing mental health problems permission to delve into themselves and to have quality time talking to someone and trying to find solutions. The service is really responsive too. When people ask for mental health support through their GP surgery now, they are going to have contact from West Sussex Mind staff within a few weeks.

The service also helps to prevent mental health problems escalating, because it is highly practical. It engages people soon after their symptoms have first shown and this early intervention is crucial. So it means that people can have early support, medication if required, and the opportunity to learn coping mechanisms and to know what to do if things escalate.

If they are on a waiting list for mental health support, people often return to see their GP if their mental health deteriorates. So enabling them to see someone more quickly and linking them into support in the community is invaluable. It’s a really well-rounded service.

You mentioned that a similar service is being offered more widely in West Sussex. Can you tell us more about that?

Following the success of the service in Adur and Worthing, surgery-based mental health support, provided by third sector partners, was then adopted in the Chanctonbury area. Again it was very successful and so much so, that in 2021, the NHS Integrated Care Board commissioned an evolution of the model, led by West Sussex Mind and United Response, which was subsequently rolled out more widely.

And now, as part of the Sussex-wide community mental health transformation project, the Emotional Wellbeing Service is being developed throughout the whole of Sussex. Soon every primary care network will have mental health support coordinators in its surgeries available to provide one-to-one sessions to people over 18 seeking mental health support through their GP.

Find out more about the mental health support West Sussex Mind provides in GP practices across West Sussex: West Sussex Mind | Our specialist workers in GP practices