People with schizophrenia and bipolar disorder (manic depression) often live very different lives from the general population. Around 66% live in poverty and isolation, most rate their quality of life as poor, and only 12% are employed. These troubling findings are related to the direct effects of mental illness, the side effects of medicines on both physical and mental functioning and peoples’ prejudices/attitudes about mental illness. Previous work suggests that many individuals with lower levels of need have minimal and poorly co-ordinated primary and specialist care. Many service users and professionals feel that too much focus is placed on medication and not enough on other aspects of life. Once stabilised on medication, services don’t always then focus on supporting these individuals to take the next steps in their recovery and fulfil their potential.
Aim of the project
PARTNERS2 aims to help primary care and community based mental health services work more closely together. The CLAHRC research team thinks this could be achieved by developing a system of collaborative care based in GP surgeries where about 70% of adult service users are seen regularly by an experienced mental health worker who acts both as overall co-ordinator (supporting individuals to access other services and activities) and therapist. This person would see the service user regularly, help them help themselves and facilitate recovery in the broadest sense and, where required, call on the talents of other parts of the health service, particularly secondary mental health care and voluntary/community organisations. GPs, psychiatrists and service commissioners in Birmingham, Manchester and South Devon have agreed to work with us to reshape services from 2013.
This multi-disciplinary research team has worked together for ten years. We know the success of this intervention depends on working closely with people with lived experience. There are ethical considerations for example around mental capacity; however the researchers hope that by working closely with service users and carers, they will be well positioned to address ethical issues as they arise. At the end of the five year Programme, they will know if collaborative care for people with schizophrenia and bipolar disorder in England is likely to work, based on the views of all the people involved in setting it up and using it, how well service users are feeling in themselves, the quality of their lives, how many feel they are more recovered, and what the system costs to run.