Recognizing and managing psychosis in primary care

Primary care practitioners have an important role to play in the management of patients with psychosis; patients want easy access and see general practitioners (GPs) as having a role in both physical and mental health care. Better physical and mental health care is achieved through improved both proactive and reactive care. These components are enhanced by high-quality practice systems and liaison with specialist services. GPs need to be alert to potential psychosis in order to facilitate early treatment during first episodes; they may be the first contact during a relapse or crisis, and well-coordinated care with specialist teams is essential at this time. Patients under specialist teams may need support from care coordinators and others to develop the trust in primary care that can facilitate improved physical care and provide an alternative point of care in times of crisis. For patients no longer in contact with specialist services, GPs need to provide proactive care, screening for psychosocial needs, and reviewing medication and mental state. Specialist workers will increasingly provide support to primary care in order to improve the quality of this GP-led care.