Description of Primhe and Statement of Purpose

Vision for Primhe

Strategic Aims

Primhe's Essence

 

Primhe is a whole person, integrated-care mental health charity dedicated and committed to improving the delivery of primary care mental health services to patients and improving the understanding of the public by:

• Providing quality educational and training initiatives, materials and meetings
• Fostering and sharing positive practice whilst encouraging its research and development
• Valuing the vocation and professional artistry of individuals involved in health and social care
• Focussing on service users' needs, goals and aspirations through therapeutic partnership
• Restoring to service users their sense of self-esteem, connection and locus of control
• Advocate for the issues of importance to those with mental illness or distress
• Promoting mental health, continuity of care, and zeroing the stigma of mental illness
• Co-ordinating the development and delivery of proven and effective care solutions
• Establishing collaborative and supportive partnerships with all concerned organisations
• Communicating its aims to, and lobbying, as wide an audience as possible

 

Primhe believes that the physical, mental and spiritual well-being of all people must be valued and viewed as inseparable. As a powerful, high-profile group it will champion the mental health of the nation.

 

To provide quality educational initiatives for primary, and also, where appropriate, secondary care professionals, so as to improve the recognition, diagnosis, treatment and management of all illnesses associated with impairment of function resulting in lost quality of life;

To promote interest in the research and development of issues relevant to primary care mental health and to disseminate and communicate such findings and information so as to maximise their impact and effectiveness on patient care;

To shape policy, develop cost-effective programmes and drive change in order to create, foster and maintain positive and effective team environments where a sense of vocation and professional artistry are highly valued;

To champion the right of all people, including health and social care professionals, to live healthy and happy lives and to defend those same professionals' key role as advocates acting in the interests of their clients'/patients' optimal mental health and well being;

To drive innovation, encourage collaboration and support equity, equality and excellence in care both through mental health promotion and by breaking down barriers to the effective treatment of mental illness;

To focus on the clients'/patients' needs and goals, develop integrated care pathways and protect the concept of continuity of care and carer, both for people with troubled minds and patients with formal mental illness, in order to deliver the best outcomes possible both at individual and societal levels;

To zero stigma and raise the awareness and maximal understanding of mental illness, human distress and associated disorders of brain function, by educating the public and media and lobbying all relevant individuals and organisations;

To encourage, initiate, foster and maintain beneficial partnerships with all relevant organisations or interested parties, raise funding for its initiatives, and take, or join with others in taking, any steps consistent with its charitable nature that may assist its aims.

These are Primhe's core beliefs, upon which all its objectives are based:

 

People are whole beings who require integrated care solutions in order to restore their sense of worth and connection to themselves and their surroundings;

This emphasis will result in greater concentration on the patient (if a formal diagnosis is involved) or person (if no such formal diagnosis is made or necessary). In the context of mental health, therapeutic intervention may well be necessary at first, in order to restore a person to optimal function, before they can clearly identify their goals. Their ability and willingness to identify such goals and aspirations should themselves be outcome measures for evaluating effective interventions. The needs, goals and aspirations of both patients and healthcare professionals are crucial to therapeutic success.

 

There is a great need to harmonise and align the various definitions and understandings of mental illness in the various disciplines and services patients encounter through being unwell;

When people become patients, they undergo a range of experiences, one of which is the exposure to the plethora of terminologies and approaches of the disciplines encountered. PCGs now offer great opportunities to work together to patient benefit, but health and social care professionals often regard each other with suspicion, if not contempt. Primhe wishes to work to help heal these rifts and wounds by enabling and providing opportunities for team building and team working.

 

In order to reflect the true spectrum of mental diseases and distress in primary care, the term "severe and enduring mental illness" should not exclusively apply to psychosis and/or the suicidal behaviour related to schizophrenia and mania, but is an operational classification that can be applied to any presenting diagnostic condition where that label is deemed to be appropriate, both by the patient and/or health professional;

Raising the profile and sharing the skills required to deal with, those disorders not mapped by the operational definition of "severe and enduring" mental illness, but which nevertheless cause massive personal and state costs in terms both of workload, funding, disability, co-morbidity, somatisation and death (e.g. addictions, eating disorders, behavioural dysfunction, stress, affective disorders, burn-out).

 

People presenting to health care professionals asking for help are entitled to expect high quality, appropriate, accessible, equitable and consistent care whoever they are and wherever they live;

It is appropriate, in a complex and constantly changing society, to realise that the NHS is now carrying the considerable burden of a highly socially mobile population lacking much of the traditional supportive infrastructure.
It is essential that patient user groups, self-management techniques and health promotion become more widely used as therapeutic interventions and that the causes and progenitors of mental distress and illness are clearly defined. It is Primhe's belief that responsibility for arriving at an effective solution for the individual(s) affected is laid firmly where it belongs.

There is also no doubt that industrial and commercial companies will increasingly assume the duty of care for support and services both to society as a whole, and to their employees, into the future and that partnership with these organisations offers considerable opportunity for more integrated health care solutions. The NHS can no longer be the final common pathway, in terms of finding and funding solutions for all these ills.

 

The overmedicalisation of human distress is to be avoided and it is crucially important that health professionals have the skills and quality time and space to allow for the provision of continuity of care;

As increasing numbers of doctors and nurses portfolio, become part-time or bank locums and the NHS develops other options for consultation, such as NHS Direct, there is a real danger that the ability of the primary carer to provide continuity will be increasingly eroded. Primhe is passionate both about the importance of continuity of care and carer, especially in those suffering from mental distress or illness, and the vital place of narrative and peopes' interpretation of their predicament.

 

The delivery of high quality care depends on a well-motivated (not just educated) workforce;

There is little doubt from published research that many working in the NHS are themselves demoralised, stressed, depressed or frankly burnt-out. This issue needs to be addressed urgently and health professionals both need new skills and attitudes to cope with the everyday demands of clinical practice and to feel that they themselves are also valued. Primhe believes that there is an ember or flame worth rekindling in many and that it is vital for people to remain in touch with why they became a nurse or doctor (allowing for the incorporation of personal experience and its influence on attitudes).

 

Education, Research and Development in mental healthcare now require a primary care focus and emphasis;

Apart from any other considerations, primary care is where 90-95% of the disease management burden is sited. A 'bubble-up' (aka 'bottom-up', non-hierarchical), rather than 'top-down' (hierarchical) approach, will be far more effective, since it encourages greater personal ownership (by both patients and health professionals), creativity, participation and evaluation in order to produce locally aligned and relevant services in the context of National Frameworks and Standards, Expert Patient Groups, Engaging Service Users, Patient-Public Involvement and Health Promotion Initiatives.

 

Greater emphasis on solutions rather than problems, action rather than procrastination, and proactive, not solely reactive, healthcare;

In the past, many therapies have made the mistake of offering themselves as being the best or only solution. In reality, human distress requires a range of effective, focussed, proven, and not mutually exclusive, options to be available and evidence-based medicine must include personal professional experience.

Too often, there is a concentration on outcome or process. The truth is that, just as light behaves as waves or particles, depending on the conditions for observing it, so it is necessary to apply both-and solutions, rather than either-or ones, in many cases.

Primary care professionals want to be able to tailor treatments to suit the individual and to have a range of evidence-based interventions available at local level. People are also better empowered, and are more concordant with treatment, if they feel, and are, involved in making informed choices regarding their management and understand how they have reached the point of need.

Further, it has also become commonplace in the so-called developed world to justify further research, rather than risk taking any action, so Primhe will lobby for the implementation of validated research findings that point the way to alleviating human mental distress.

 

The funding engine will potentially consist of all organisations identified as relevant to the remit of Primhe and its quest to optimise the individuals mental health in their personal, social and occupational contexts. Those involved in sponsor activity or partnership are not part of Primhe, rather, they are as much Primhe as any of its operational or executive components;

This engine will not consist solely of those involved in the surgery consultation with a doctor or nurse (that is, traditionally, the pharmaceutical industry): rather, it will track with the patient-user to include employers, companies, organisations (both public and private), private health providers, NHS, health insurers and pension providers, since all these (and others) impinge on personal mental health.

It is time for the brain, together with its functions in relation to mental illness, to make its appearance on the public and primary care stage and for health professionals to be given the latest information about, and be trained in the latest methods in, dealing with it;

This will both serve to increase everyones respect for it, and prompt the realisation that mind is but one of the brains myriad functions and that affective disorders, for example, result from exogenous and endogenous factors producing dysfunction that is just as physical as any other more socially perceived organic diseases such as epilepsy, Parkinsons disease or stroke. We also need to understand better what brings a person (or their carer) to seek help regarding their mental health, given the stigma associated with mental illness in the first place.

Primhe will encourage and provide opportunities for debating such issues as "Mind over matter" and "Its all in the mind". Primhe will also work to reduce stigma and the eradication of out-moded advice. Medical education and the media also now need to reflect these changes and enable ample opportunity for informed debate surrounding the many issues that our new understanding and old-fashioned attitudes raise for a society where the accent too often is on the exploitation of people with all the attendant consequences to the NHS.

Primhe will also be involved at undergraduate and postgraduate levels with ensuring that healthcare students are exposed to opportunities for debating and understanding their own attitudes towards frailty, distress and formal mental illness. At a more general level, Primhe will work in schools and educational establishments to promote mental health and healthy attitudes towards mental illness.