Adequate staffing and shared commitment are needed

EDITOR—In their editorial Phelan et al correctly highlight the importance of general practitioners assessing the physical health of patients with severe mental illness.1 Although we share their belief that the success of this is reliant on practices identifying these patients, our research suggests that this task is far from straightforward.

Our three year study was sited in an English health district where the NHS trust and health authority had collaborated in establishing registers of cases of severe and enduring mental illness in over 60 general practices.2 The aim was to identify all practice patients with severe mental illness as a first step in raising their profile in practices. Each practice had been allocated a named community mental health nurse, and these link nurses were given a key role in developing the mental health registers in consultation with general practitioners and practice staff. During the study we carried out 42 in depth interviews with the professional staff …