Dear doctors, researchers, and colleagues,
The theme of the Dublin EGPRN conference, being hosted by the ICGP in conjunction with UCD Academic General Practice, is Mental Health in Primary Care: Public and Patient Involvement in Research. Both the ICGP and UCD have a track record of service programmes and research projects in the area of mental health and related areas and have chosen this topic for the conference in order to further highlight the central role of primary care within the field of mental health, which is a global phenomenon with policy makers actively encouraging primary care to take a lead role in developing mental health services. They are collaborating currently on a longitudinal study of people with enduring mental health to investigate and improve their physical health and its monitoring. Previous research in this area includes topics such as schizophrenia in general practice and mental health consultations in out of hours.
Mental disorders are widespread with an estimated 25% of people experiencing such problems at some point in their lives and approximately 10% of the adult population experiencing a mental disorder at a given point in time (WHO 2001). Research suggests that morbidity and mortality rates are higher among individuals with serious mental health issues (Dixon 1999; Lambert et al. 2003; Osborne et al. 2003, 2007a, 2007b; Robson 2007; Wahlbect et al. 2011; De Hert et al. 2011). The economic impact of mental health problems is considerable. Within mental health, depression affects approximately 5% to 10% of people and is the third most common reason for consultation in general practice (Singleton et al. 2001). By 2020, depression will be the second most common cause of disability worldwide (Murray and Lopex 1997). One study from England estimated the total costs of adult depression alone to be £15.46 billion; treatment costs accounted for £636 million, with the majority of additional costs being due to lost employment because of absenteeism and premature mortality (Thomas and Morris 2003).
For those with a diagnosed mental health issue/illness, structural and systemic health disparities impact on access to and utilisation of health care. Mental illness acts as barrier to accessing and obtaining effective medical care (Lambert et al. 2003).The majority of those who do receive treatment do so in primary care with only a small minority consulting more specialised mental health services (European Commission 2006).
However, there is unanimous consensus from the international literature that general practice has a central role in the provision of medical treatment and preventative health care to people with a severe mental illness (Victoria Government 2008). The central role of primary care within the field of mental health is a global phenomenon with policy makers actively encouraging primary care to take a lead role in developing and delivering mental health services (Rogers and Pilgrim 2003).
"Involving patients actively in research represents a significant culture change and requires a number of barriers to be addressed including people’s attitudes and levels of awareness." (European Science Foundation, 2010). PPI describes a whole variety of ways that researchers engage with people for whom their research holds relevance. PPI:
It is important to put PPI in research in the wider context of PPI in all aspects of health policy. In recent years there have been a number of significant developments in this regard. The World Health Organisation Declaration of Alma Ata "People have the right of duty to participate individually and collectively in the planning and implementation of their healthcare" (http://www.who.int/publications/almaata_declaration_en.pdf).
There is a need to avoid overly prescriptive or narrow definitions of PPI. The challenge is to mainstream PPI in all aspects of research and health policy and structures going forward, which will require significant political leadership and a new overall strategy.
The conference will be opened by the Irish Minister of State for Mental Health and Older People, Jim Daly and keynote speeches will be delivered by Prof Amanda Howe, UEA & President of WONCA and Prof Andrew Murphy, NUI Galway.