Introduction

Enhanced Services for depression are a mechanism to commission improved primary mental health care for patients with depression. This website is intended to assist Primary Care Trust (PCT) mental health and primary care commissioners, and GP practices, in the implementation of an Enhanced Service for depression.

It will be essential for mental health and primary care commissioners to work closely together in developing this area of commissioning. PCTs will also need to work with practices and Local Medical Committees.

The main challenges for both primary care and mental health commissioners will be to overcome key issues, such as the lack of a structured approach to the development of the primary care component of mental health care, lack of mental health training for primary care clinicians, and insufficient therapeutic options for the care of patients with common mental illness in primary care.

This will require mental health commissioners to develop improved access to a range of psychological therapies in primary care, to mental health assessment (where required), and a strengthening of the primary/secondary care interface. There are also opportunities around the redesign of existing services such as CMHTs and counselling services, and the introduction of new workers such as graduate workers and practitioners with a special interest.

The challenge for primary care commissioners will be to engage GPs and their practices in the development of mental health care. This enhanced service specification will be the mechanism to achieve that by the explicit commissioning of the practice level component of the whole system of care. It will be an extensive and ongoing area of work and will present challenges to commissioners. However, the benefits to the whole system of health care will be significant if this integration is achieved.