Mental health issues in primary care: implementing policies in practice.

Recent health policies highlight the important role that mental health contributes to our general wellbeing, and call for parity of esteem between physical and mental health. The bidirectional relationship between physical and mental health culminates in high prevalence rates of mental disorders in primary care settings. Despite these prevalence findings being known for some time, evidence would suggest that at times mental disorders are being overlooked. This article, set in context to policy, patient prevalence, practice and professional development, outlines a range of factors that can impede mental health delivery and proposes ways in which primary care nurses can strengthen their activity and involvement at various levels.

Cognitive behavioural therapy and its relevance to nursing.

Over the last 20 years, cognitive behavioural therapy (CBT) has gained considerable momentum in mental healthcare practice. Its extensive evidence base for the treatment of mental health problems is well documented with the National Institute for Health and Clinical Excellence (2007a; b), which has recommended CBT as a key treatment modality in its best practice guidelines. More recently, the use of CBT has widened to a diverse range of physical healthcare environments, including dentistry, occupational therapy, palliative care and physiotherapy (Chartered Society of Physiotherapists, 2004; Buchanan and Zakrzewska, 2008; Donaghy et al, 2008; Hesslop, 2009), with preliminary research highlighting its use in improving patient outcomes both in terms of reduction in morbidity and improved quality of life. In this article, the authors outline the principles and techniques of CBT, give examples of how this form of psychotherapy can be applied within nursing practice, and discuss the theoretical and practical underpinnings that align CBT and nursing.

Psychological issues surrounding paternal perinatal mental health.

It has become widely accepted that the perinatal period can be a time of heightened risk for mental health problems and emotional responses in women. However, there has been less research on men in this area and it has remained a somewhat neglected area. While perinatal mental health services are increasing for women, few exist for men. While the author acknowledges the greater impact perinatal mental health problems can have on women, this article explores psychological issues relating to paternal perinatal mental health.

Improving perinatal mental health care.

Pregnancy and the puerperium can bring many emotional, physical and social changes to the mother, her partner and the rest of the family. While many mothers find these changes--such as the experience of pregnancy or the addition of a new member to the family--joyous, some do not share these positive feelings and often undergo emotional upheaval resulting in severe biopsychosocial distress. This period of distress does not only subject the mother and her family to increased risk of psychological crisis, mental illness and developmental disturbances, but may also, if untreated, result in the fatalistic outcomes of infanticide or suicide. In this article, the author calls for a more robust, co-ordinated and interdisciplinary approach to perinatal mental health services.