A recent study that was published in the Journal of Affective Disorders concluded thatlifestyle advice was more effective than standard GP care in tackling anxiety. How manyof us are surprised? In a typical workday, we expect a significant psychologicalcomponent in up to 60-70% of our consultations, yet most of us do not have thepsychological tools to deal with these patients and currently there are only a few drugslicensed for anxiety, and most of these are for short term only. Venlafaxine is a recentnote-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 theircompetence and outside of their medico-legal cover. This is a very serious situationfor such people, as well as being, rightly, a cause of concern if effectiveness and costbenefitare 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, orpalpitations 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 wrongwith 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 theconsulting room with the patient. As long ago as the 1960s studies by Stoekle et al in the UKand by Cummins & Follette in the USA were showing that between 50 and 60% of medicalsymptoms of patients could not be explained by the medical profession. The traditional medicalmodel of training teaches that every symptom is potential underlying disease. In practice, thepatient seems not to read the same medical textbooks as we do and rarely do their symptomsneatly 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 themain classification systems for psychiatric disorders are due to be revised. The questionis: 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 itdepresses patients and their carers and stigmatises them at home and at work. Patientsconstantly tell me how unhelpful they find it, and many simply reject the term.

The United Kingdom Royal College of General Practitioners recognises that mentalhealth problems in primary care are common and that the range of mental healthproblems encountered by a GP is large. Around 30% of people who see their GPhave a mental health component to their illness .Whilst 80% of all contacts in theBritish National Health Service (NHS) take place in primary care, which receives20% of NHS resources, 90% of people with mental health problems are cared forentirely within primary care, but use less than 10% of the total expenditure spent onmental health. Those with severe mental illness, who may have their mental illnesscared for in secondary care, have a high prevalence of physical co-morbidity thatshould be looked for and treated by general practitioners.

Extracts mainly taken from First (2006) and second (2007) reports from the UK Inquiry into Mental Healthand 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 careoutside hospitals. It reinforced the importance of services provided by healthcareprofessionals working in community settings. The public involved in the consultationprocess that informed the White Paper made it clear that while convenient care wasimportant, it must be of high quality and that a transparent process should underpin thatquality.

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

Recent policy changes in the National Health Service (NHS) have meant thatprimary care now leads much of the development and delivery of mentalhealth services in the United Kingdom (UK). It is therefore important to assessthe 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 andmonitoring of practitioners with special interests (PwSIs: GPs, dentists and pharmacists)by 2009-10. PCTs have to reaccredit their existing PwSIs by March 2009 in accordancewith the guidance.

A carer is someone who, without payment, providessupport to a partner, child, relative, friend or neighbourwho could not manage without their help. This could bedue to age, physical or mental illness, addiction ordisability.