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Open Access Research article

Aiming to improve the quality of primary mental health care: developing an intervention for underserved communities

Carolyn Chew-Graham1, Heather Burroughs1*, Derek Hibbert3, Linda Gask2, Susan Beatty2, Katja Gravenhorst3, Waquas Waheed2, Marija Kovandžić3, Mark Gabbay3 and Chris Dowrick3

Author Affiliations

1 Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK

2 Institute of Population Health, University of Manchester, Manchester, UK

3 Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK

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BMC Family Practice 2014, 15:68  doi:10.1186/1471-2296-15-68

Published: 16 April 2014



The purpose of the study was to improve the quality of primary mental healthcare in underserved communities through involvement with the wider primary care team members and local community agencies.


We developed training intended for all GP practice staff which included elements of knowledge transfer, systems review and active linking. Seven GP Practices in four localities (North West England, UK) took part in the training. Qualitative evaluation was conducted using thirteen semi-structured interviews and two focus groups in six of the participating practices; analysis used principles of Framework Analysis.


Staff who had engaged with the training programme reported increased awareness, recognition and respect for the needs of patients from under-served communities. We received reports of changes in style and content of interactions, particularly amongst receptionists, and evidence of system change. In addition, the training program increased awareness of – and encouraged signposting to - community agencies within the practice locality.


This study demonstrates how engaging with practices and delivering training in a changing health care system might best be attempted. The importance of engaging with community agencies is clear, as is the use of the AMP model as a template for further research.

Mental health; Underserved populations; Primary care