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Mental Health Toolkit

Mental-health-toolkit

Approximately a quarter of all people will experience a mental health problem in the course of a year, and 23 out of 30 who experience mental health problems will visit their GP. The RCGP believes that accessible, high quality primary care is vital to keeping patients healthy for longer. As such, a holistic approach is required promoting mental health equally and in partnership with physical health.

Background

The Mental Health Toolkit provides resources for healthcare professionals to reference regarding the diagnosis and treatment of mental health problems. The toolkit provides trigger questions, diagnostic tools, and current guidance for healthcare professionals supporting those with mental illness. It also provides resources for those concerned about their own mental health issues

Who is the Mental Health Toolkit for?

The Mental Health Toolkit may be used by any general practice in the UK. The resources it provides can be used by healthcare professionals to support their assessments and enhance their knowledge and care of patients. Patients, carers, and GPs concerned about their own mental health, may also find the toolkit useful.

Clinical resources and guidance for practices

The following tools may be used for recognising, diagnosing and helping patients with a mental illness.

Care pathways and clinical guidance

The following resources aim to improve identification and provide advice on the assessment of mental health conditions, and advice on treatment pathways

Information factsheets for clinical guidance

The following factsheets offer guidance for approaching a range of common situations which may cause mental health problems for patients. 

Perinatal mental health

The following resources specifically focus on perinatal mental health, and provide best practice and treatment pathways, as well as national guidelines.

Mental health in partnership with physical health

Mental health and smoking

People with mental health problems die on average 10 to 20 years earlier than would otherwise be expected, and a large proportion of this difference is due to tobacco use.

Dementia

Mental Capacity

Quality Improvement

To access shared learning networks to assist you in applying practical QI methodologies to better treat this clinical area, join our QI Ready platform.

Resources for practitioners (Top tips)

The following factsheets offer guidance for approaching a range of common situations which may cause mental health problems for patients. 

Suicide and crisis care

Crisis care

The mental health crisis care concordat is a national agreement between services and agencies involved in the care and support of people in crisis. It sets out how organisations will work together better to make sure that people get the help they need when they are having a mental health crisis. The resources below can be useful within mental health crisis care:

Suicide prevention and risk assessment

The following tools assist GPs in the recognition of suicide risk, and give clinical guidance for assisting those who may be at risk of taking their own life:  

Suicide bereavement resources

Children and young people’s mental health

One in ten young people aged 5 to 16 suffer from a mental health disorder. The following links offer toolkits and pathways you may find useful when helping a young person who is displaying signs which may be linked to mental health issues:

Factsheets

Resources for children and adolescents

  • Beat eating disorders
  • Coping with self-harm: A guide for parents and carers by the Centre for Suicide Research at the University of Oxford
  • Big White Wall a community of people who are anxious, down, or not coping
  • Youth in mind For stressed children and teenager, and those who care for them
  • Calm harm provides tasks that help the young person resist or manage the urge to self harm.  They can add their own tasks too and it’s completely private and password protected.
  • No Harm Done Three short films, co-created with young people, parents and professionals, reflecting their real-life experiences of self-harm

Publications

Mental health in older adults

Diagnosing a mental health problem

The NHS England Practice Primer is a valuable resource for GPs which provides guidance on the diagnosing and managing common mental health problems in older people, highlighting differences in treatment compared to younger patients. It also offers tips on when to refer to secondary care.

Depression in older adults

The primary care management of depression in older adults is summarised in this 'Management of Depression in Older People:Why this is Important in Primary Care' document.

The MDTea podcasts presented by geriatricians Dr Preston and Dr Wilkinson include a podcast on depression in older adults, and accompanying education notes.

The RCGP e-learning offers a module on depression in older adults (add link). About 20% of all suicides occur in older people, and suicide attempts in this age group are more likely to represent a true wish to die. The RCGP module on suicide prevention covers this in more detail (add link).

Improving access to psychological therapies for older adults

Referral rates to psychological therapy of older patients with mental health problems have persistently lagged behind those of younger patients. A recent 'Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies' review has sought to understand why. 

The University of East Anglia offers a series of educational workbooks to help overcome the barriers to access for older people to psychological therapies. These booklets are primarily aimed at CBT therapists.

Discussing symptoms with patients

The Royal College of Psychiatrists has an excellent series of patient information leaflets. These are valuable to GPs to guide consultations. Topics of particular relevance to older adult mental health are depression in older adults, coping with physical symptoms, and medically unexplained symptoms. 

Age UK has produced a 'Your mind matters: Ideas and tips for emotional wellbeing' booklet, which offers advice to older adults on strategies for improving their mental wellbeing. It also describes the mental health symptoms that should prompt a visit to the doctor, and includes some useful links to charitable organisations. 

Patients at risk

Being a carer is a significant risk factor for ill health, both physical and mental. The ' A practical guide to healthy caring' for carers offers helpful advice on keeping well, taking breaks, as well as a list of contacts.

Having a long-term condition is a risk factor for depression. Parkinson’s disease in particular is associated with significant depression and anxiety. A recent parliamentary enquiry exposes the widespread unmet needs of patients with Parkinson’s disease, and calls for improved access to tailored psychological therapies. The survey reports that 75% of patients with Parkinson’s disease feel their mental health impacts on their quality of life. With this in mind, as GPs we can ensure we probe routinely into the mental health of our patients with Parkinson’s disease to establish whether treatment is required.

A selection of recent policy documents are listed below.

Resources and guidance for patients and carers

The following resources can be passed to patients, and people close to them

Charities

The following charities may be used by patients to learn more about their mental health condition, and read case studies of others who have suffered and been treated for them. They also provide a handy contact resource for questions outside of GP surgery hours.

Self help resources for patients

How to discuss mental health with your GP

Speeding up return to work

  • Fit for work - a free service for people who have been off work, or are at risk of being off work, for 4 weeks or more. People can self-refer, be referred by their employer or by their GP. It provides occupational health assessments and support aimed at enabling a safe and speedy return to work.

Cognitive Behavioural Therapy resources (all free but some require registration)

Resources for carers

Prevention and wellbeing resources

The following resources may benefit a patient suffering from mental distress, who does not yet want or require treatment:

Supporting healthcare professionals’ mental health

Many doctors find it hard to acknowledge their own mental health issues and put off seeking help. The following resources are aimed towards supporting healthcare professionals cope with stress and other issues which may arise as a result of practising medicine.

Trainees in difficulty can contact the Professional Support Unit in their respective deaneries for free support with ill health while training.

National guidelines and reports

Current national and legal guidelines for healthcare professionals to follow regarding mental health issues:

English and Scottish guidelines

Mental Healthcare in other nations

Training and appraisal resources

The RCGP training curriculum for mental health issues ensures GPs start with an understanding of the demands of working with people with mental health problems and the need to make sure they remain healthy. The following resources may be accessed for continuing and developing this purpose, and for providing evidence for Appraisal and Revalidation.

RCGP elearning modules

Other elearning

Background and information for commissioners

Developed in partnership with the Clinical Innovation and Research Centre, the guidance and resources within the Mental Health toolkit reflect current guidelines. They provide a toolkit to which general practitioners may refer to recognise and diagnose mental health conditions, as well as suggesting the best management options for a particular patient.

Commissioning Information

Suicide bereavement resources

Policies and Reports

The Mental Health toolkit has been developed in partnership with the Clinical Innovation And Research Centre. Please send any comments or suggestions to circ@rcgp.org.uk

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