How mental health services are changing in north London

Dr Ian Prenelle, consultant psychiatrist at the Kentish Town Core Team

Dr Ian Prenelle, consultant psychiatrist with the Kentish Town Core Team - Credit: Dr Ian Prenelle

Thousands more people in north London will soon be able to access mental health support, according to NHS bosses.

A three-year, £25m, cross-borough transformation programme began in Kentish Town in July, and will see mental health services available through all GP practices in Camden from April.

So far, about 150 staff have been recruited, with many more to follow in the next few years also covering Barnet, Enfield, Haringey and Islington which are on a different stage of the journey.

Key to the whole scheme is prevention, to help people reduce their risk of long-term negative mental and physical outcomes.

Rather than a patient seeing one person, new "core teams" include psychiatrists, mental health nurses,  psychologists, and peer coaches, who are people who have been through mental illness and recovered and done some training on how to support others based on their own experience.

Dr Ian Prenelle, consultant psychiatrist at Kentish Town Core Team, said there will be capacity to help thousands more people.

"We haven't replaced anything about the existing system, we've just added," he said.

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"One of the main motives for setting up the new teams is to plug the gaps with the existing service.

"It's not as if we're promising to offer long term in-depth therapy for everyone, that's impossible.

"It's more that you won't have to wait months and years for an assessment, you'll be seen very quickly, you'll be offered some form of help very quickly.

"These new services see people in a much more holistic way so it might be something happened in the past that people have to work through or it might be the main problem they feel in the present such as stress or bereavement or lost their job.

"We can work with people over a long period of time but possibly not continuously." 

Depending on their assessment, a person might work with a psychiatrist for a few sessions, followed by a peer coach, they might join a facilitated group, get support from a voluntary worker, such as housing advice.

Dr Prenelle said that, since 2012, specialist mental health teams have focused on particular sorts of mental illnesses, such as depression and anxiety, post-traumatic stress disorder or psychosis. 

"What we found is that there are quite big gaps between specialist services and lots of people who don't quite fit into diagnostic groups," he said.

"There are also lots of people who have fluctuating mental health in the community but they don't ever quite reach the level of severity to be referred to a specialist mental health services."

The five boroughs will be covered by mental health core teams closely integrated with GP practices within primary care networks. 

"The Core Teams are much more holistic in their approach and interested in helping people with their physical health as well as their mental health," added Dr Prenelle, who is also Camden's clinical director.

He said people with schizophrenia or bipolar disorder are on average more likely to have higher rates of heart disease, diabetes, lung conditions and high blood pressure.

"People with those conditions are more likely to be higher risk of dying younger, some by 20 years," he said.

"Historically that risk was neglected. GPs would try and manage that but that would be quite distinct from what mental health services would do.

"We are specifically trying to join up people's physical and mental health care, particularly to reduce these risk factors for heart disease and diabetes, the things that lead to a shorter life expectancy for those people with a major mental illness."

People will be offered physical health checks and wellbeing health checks with signposting to community resources and services to help support them emotionally, psychologically, socially and physically.

"This is based on our understanding that our mental wellbeing is closely linked to our social wellbeing with loneliness as a major factor for determining outcomes for things like depression and anxiety.

"If people are socially isolated, they are more likely to have poor mental health and if they have poor mental health, they are likely to have poor physical health." 

He added: "It's really exciting. I've been a psychiatrist since 1994 and rarely do we get a chunk of new investment to do something in a definitive way."