Getting a balance between generalisation and specialisation in mental health services: A defence of general services

Richard Laugharne*, Matthew Thompson, Alind Srivastava, Simon Marlow, Rohit Shankar

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Mental health services in the UK National Health Service have evolved to include primary-care generalist, secondary-care generalist and secondary-care specialist services. We argue that there continues to be an important role for the secondarycare generalists as they minimise interfaces, can live with diagnostic uncertainty and support continuity of care. The lack of commissioning and clinical boundaries in secondary-care generalist services can undermine their feasibility, leading to difficulties recruiting and retaining staff. There is a risk of a polo-mint service, where the specialist services on the edge are well resourced, but the secondary-care generalist services taking the greatest burden struggle to recruit and retain clinicians. We need to establish equity in resources and expectations between generalist and specialist mental health services. Declaration of interest None.

Original languageEnglish
Pages (from-to)229-232
Number of pages4
JournalBJPsych Bulletin
Volume42
Issue number6
DOIs
Publication statusPublished - 17 Jul 2018

ASJC Scopus subject areas

  • Psychiatry and Mental Health

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