A recent study that was published in the Journal of Affective Disorders concluded that lifestyle advice was more effective than standard GP care in tackling anxiety. How many of us are surprised? In a typical workday, we expect a significant psychological component in up to 60-70% of our consultations, yet most of us do not have the psychological tools to deal with these patients and currently there are only a few drugs licensed for anxiety, and most of these are for short term only. Venlafaxine is a recent note-worthy one.

The Department of Health could claim that the new grade of GPwSI is a success as they have exceeded their target numbers but others may argue that at least some 'GPwSIs' are currently potentially, if not actually, practicing beyond their competence and outside of their medico-legal cover. This is a very serious situation for such people, as well as being, rightly, a cause of concern if effectiveness and costbenefit are also not being evaluated.

General Practice is a complex affair. Our patients persistently frustrate us. They fail to read the medical textbooks and to get the proper diseases that we were taught to diagnose in medical school. Instead they persistently present with a confusing array of symptoms so that in the vast majority of cases, we will not diagnose an underlying medical cause. They come with headaches, fatigue, dizziness, numbness, or palpitations and we spend valuable resources doing multiple tests to reassure them, telling them that there is nothing to worry about as there is nothing medically wrong with them. Medication will not cure such patients, so how best do we help them?

Anyone who works in general practice will know the variety of baffling symptoms that enter the consulting room with the patient. As long ago as the 1960s studies by Stoekle et al in the UK and by Cummins & Follette in the USA were showing that between 50 and 60% of medical symptoms of patients could not be explained by the medical profession. The traditional medical model of training teaches that every symptom is potential underlying disease. In practice, the patient seems not to read the same medical textbooks as we do and rarely do their symptoms neatly fit into a simple disease category.

I believe that as a GP we should not prescribe antidepressants to children as it has become apparent that the brain is still developing and they can interfere with this. All efforts should therefore be made to treat the child with talking therapies.

IN 2011, schizophrenia will be 100 years old. This also happens to be the year in which the main classification systems for psychiatric disorders are due to be revised. The question is: does the term "schizophrenia" deserve to survive into its second century? Most patients would say no. In my work I find the diagnosis very difficult to use because it depresses patients and their carers and stigmatises them at home and at work. Patients constantly tell me how unhelpful they find it, and many simply reject the term.

The United Kingdom Royal College of General Practitioners recognises that mental health problems in primary care are common and that the range of mental health problems encountered by a GP is large. Around 30% of people who see their GP have a mental health component to their illness .Whilst 80% of all contacts in the British National Health Service (NHS) take place in primary care, which receives 20% of NHS resources, 90% of people with mental health problems are cared for entirely within primary care, but use less than 10% of the total expenditure spent on mental health. Those with severe mental illness, who may have their mental illness cared for in secondary care, have a high prevalence of physical co-morbidity that should be looked for and treated by general practitioners.

Extracts mainly taken from First (2006) and second (2007) reports from the UK Inquiry into Mental Health and Well-Being in Later Life, coordinated by Age Concern

The White Paper Our health, our care, our say: a new direction for community services, published in 2006, set out the vision for the future of care outside hospitals. It reinforced the importance of services provided by healthcare professionals working in community settings. The public involved in the consultation process that informed the White Paper made it clear that while convenient care was important, it must be of high quality and that a transparent process should underpin that quality.

Objective: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness. respectively.

Recent policy changes in the National Health Service (NHS) have meant that primary care now leads much of the development and delivery of mental health services in the United Kingdom (UK). It is therefore important to assess the quality of mental health care in the primary care setting. respectively.

In 2007 DH set out requirements for PCTs to have processes in place for accreditation and monitoring of practitioners with special interests (PwSIs: GPs, dentists and pharmacists) by 2009-10. PCTs have to reaccredit their existing PwSIs by March 2009 in accordance with the guidance.

A carer is someone who, without payment, provides support to a partner, child, relative, friend or neighbour who could not manage without their help. This could be due to age, physical or mental illness, addiction or disability.