Skip to main content Accessibility help
×
Home
Hostname: page-component-7f7b94f6bd-dwjtz Total loading time: 0.346 Render date: 2022-06-30T03:37:58.340Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Community Psychiatric Nurses in Primary Health Care

Published online by Cambridge University Press:  02 January 2018

Kevin Gournay*
Affiliation:
Faculty of Social Science and Education, Middlesex University, Enfield
Julia Brooking
Affiliation:
Department of Nursing Studies, The Medical School, University of Birmingham
*
Professor K. Gournay, Professor of Mental Health, Middlesex University, Enfield, Middlesex EN3 4SF

Abstract

Background.

Community psychiatric nurses (CPNs) are increasingly working in primary health care with non-psychotic patients. This study was designed to test the efficacy of this work.

Method.

The study was carried out in six health centres in north London with a total of 36 participating general practitioners (GPs) and 11 CPNs. Using a randomised controlled trial, 177 patients were referred by their GP and randomly allocated to continuing GP care, immediate community psychiatric nursing intervention, or placed on a 12-week waiting-list, after which time the patient was offered CPN intervention. A range of measures of symptoms and social function were used, and ratings were carried out at assessment and at 24 weeks.

Results.

Patients improved on all measures over time (P < 0.001 for all measures). However, there was no difference between the group of patients receiving GP care and patients seen by the CPN. Improvements seemed to be independent of the amount of contact. Drop-out rates from CPN intervention were high (50%). CPN drop-outs were more disabled to start with, but did as well as CPN treatment completers. Patients were more likely to drop out with trained than untrained CPNs. There was no evidence that referral to a CPN saved GP time.

Conclusions.

The results add weight to the argument that CPNs should refocus their activity on people with serious mental health problems, and indicate that CPN education should focus on skill acquisition and interventions of proven effectiveness.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1994 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Balestrieri, M., Williams, P. & Wilkinson, G. (1988) Specialist mental health treatment in general practice. A meta analysis. Psychological Medicine, 18, 711717.CrossRefGoogle ScholarPubMed
Barratt, E. (1989) Community psychiatric nurses: their self perceived roles. Journal of Advanced Nursing, 14, 4248.CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.CrossRefGoogle ScholarPubMed
Brooker, C. (1990) A description of clients nursed by CPNs. Journal of Advanced Nursing, 15, 155166.CrossRefGoogle Scholar
Brooker, C., Tarrier, N., Barrowclough, C., et al (1992) Training community psychiatric nurses for psychological intervention. British Journal of Psychiatry, 160, 836844.CrossRefGoogle Scholar
Freeman, G. K. & Button, E. J. (1984) The clinical psychologist in general practice: A six year study of consulting patterns for psychosocial problems. Journal of the Royal College of Practitioners, 34, 377380.Google ScholarPubMed
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire: A Technique for the Identification and Assessment of Non-Psychotic Illness. Oxford: Oxford University Press.Google Scholar
Goldberg, D. P., Cooper, B., Eastwood, M., et al (1970) A Standardised Psychiatric Interview for use in community surveys. British Journal of Preventive and Social Medicine, 24, 1823.Google Scholar
Gournay, K. J. M. & Newell, R. (1993) A National Follow-up of Nurse Behaviour Therapists. Research Monograph, Health Research Centre, Middlesex University.Google Scholar
Gournay, K. J. M., Devilly, G. & Brooker, C. (1993) A study of the process of assessment. In Community Psychiatric Nursing Research vol. 2 (eds Brooker, C. & White, E.). London: Chapman & Hall.Google Scholar
Gournay, K. J. M., & Brooking, J. (1993) Failure and dissatisfaction. In Community Psychiatric Nursing Research, vol. 2 (eds Brooker, C. & White, E.). London: Chapman & Hall.Google Scholar
Hawton, K. & Kirk, J. (1989) Problem solving. In Cognitive Behaviour Therapy for Psychiatric Problems (eds Hawton, K. et al). Oxford: Oxford Medical.Google Scholar
Hoult, J. (1986) Community care of the acutely mentally ill. British Journal of Psychiatry, 149, 137144.CrossRefGoogle ScholarPubMed
Lloyd, K. (1993) The epidemiology of neuroses: neurotic disorders in primary care. Current Opinion in Psychiatry, 6, 179183.CrossRefGoogle Scholar
Mann, A. H., Jenkins, R. & Belsey, E. (1981) The twelve month outcome of patients with neurotic illness in general practice. Psychological Medicine, 11, 531550.CrossRefGoogle ScholarPubMed
Marks, I. M. (1985) Psychiatric Nurse Therapists in Primary Care. London: RCN Publications.Google ScholarPubMed
Marks, I. M., Connolly, J., Hallam, R., et al (1977) Nursing in Behavioural Psychotherapy. London: RCN Publications.Google ScholarPubMed
Muijen, M., Marks, I. M., Connolly, J., et al (1992) Daily Living Programme. Preliminary comparison of community versus hospital based treatment for the seriously mentally ill. British Journal of Psychiatry, 160, 372378.CrossRefGoogle ScholarPubMed
Mulhall, D. J. (1978) Personal Questionnaire Rapid Scaling Technique. Windsor: NFER.Google Scholar
Paykel, E. S. & Griffith, J. H. (1983) Community Psychiatric Nursing for Neurotic Patients. London: RCN Publications.Google ScholarPubMed
Spielberger, C., Gorsuch, R. & Lushene, R. (1970) State Trait Anxiety Inventory Manual. Palo Alto: Consulting Psychologist Press.Google Scholar
Tennant, C., Bebbington, P. & Hurry, J. (1981) The short-term outcome of neurotic disorders in the community: the relation of remission to clinical factors and the neutralising life events. British Journal of Psychiatry, 139, 213220.CrossRefGoogle Scholar
Test, M. A. & Stein, L. I. (1980) Alternative to mental hospital treatment. Archives of General Psychiatry, 37, 409412.CrossRefGoogle ScholarPubMed
Thomas, R. V. R. & Corney, R. H. (1993) The role of the practice nurse in mental health: a survey. Journal of Mental Health, 2, 6572.CrossRefGoogle Scholar
White, E. (1991) Third Quinquennial Study of Community Psychiatric Nursing Research Monograph. Department of Nursing Studies, University of Manchester.Google Scholar
Wilkinson, G., Allen, P., Marshall, E., et al (1993) The role of the practice nurse in the management of depression in general practice: treatment adherence to antidepressant medication. Psychological Medicine, 23, 229237.CrossRefGoogle ScholarPubMed
Wooff, K. & Goldberg, D. (1988) Further observations on the practice of community care in Salford: differences between community psychiatric nurses and mental health social workers. British Journal of Psychiatry, 153, 3037.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.
77
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Community Psychiatric Nurses in Primary Health Care
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Community Psychiatric Nurses in Primary Health Care
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Community Psychiatric Nurses in Primary Health Care
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *