The term psychosis embraces major psychiatric disorders such as schizophrenia and bipolar disorder in which a person’s perception, thoughts, mood, and behaviour are significantly altered. These disorders are often highly distressing for individuals and their families. Moreover they may be subject to considerable ignorance and discrimination among the general public and healthcare professionals.
In primary care there is a common belief that recovery from serious mental illness is impossible, despite evidence that at least 15% of people recover completely and over 50% achieve good social recovery. We now know that prompt treatment of a first episode of psychosis can improve longer-term outcomes. And benefits are evident from targeting support towards families, many bewildered and frightened as they face up to long-term commitments. We also know that longer-term impacts, such as a 15-20 year reduced life expectancy mainly from physical co-morbidities, may be potentially mitigated by attending to reversible risk factors, no different to those facing the general population and already familiar to primary care.
This workshop will challenge unduly pessimistic attitudes and encourage discussion about how primary care, with its foundation in ongoing narrative, holism and family-centered care, is uniquely placed to support these individuals and their families.
Professor Christopher Dowrick
Dr David Shiers
Christopher Dowrick is Professor of Primary Medical Care in the University of Liverpool and a GP in north Liverpool. He is also Professorial Research Fellow in the University of Melbourne, member of the WONCA’ working party on mental health and a technical expert for the WHO mhGAP programme. His research portfolio covers common mental health problems in primary care. He critiques contemporary emphases on unitary diagnostic categories and medically-oriented interventions, and highlights the need for socially-oriented perspectives. He is currently investigating equity of access for people from marginalised communities, and exploring the concept of self in primary care encounters.
David Shiers is an Honorary Reader in Early Psychosis in Manchester University, a former GP in N.Staffordshire and father to a daughter with schizophrenia. From initial complaints about his daughter’s care in the late 90s, David embraced Early Intervention in Psychosis reform to avoid other families experiencing what his had. David led with Jo Smith the UK’s National Early Intervention in Psychosis Programme (2004-10). David’s current interest is in questioning why poor physical health should be inevitable for people like his daughter, participating in relevant NICE guidance and quality standards, and as clinical advisor to two National Audits of Schizophrenia (2011-15).