Background: Common mental health disorders (CMDs) are especially prevalent amongst people from socioeconomically disadvantaged backgrounds. Non-pharmaceutical primary care interventions, such as social prescribing and collaborative care, provide alternatives to pharmaceutical treatments for CMDs. Little is known about the impact of these interventions for socioeconomically disadvantaged patients. Aim: To synthesise evidence for the effects of non-pharmaceutical primary care interventions on CMDs and associated socioeconomic inequalities. Design and setting: Systematic review of quantitative primary studies published in English and undertaken in high-income countries. Method: Six bibliographic databases were searched (Medline, ASSIA, CINAHL, Embase, PsycInfo and Scopus) and additional grey literature sources screened. Data were extracted onto a standardised proforma and quality assessed using the Effective Public Healthcare Panacea Project (EPHPP) tool. Data were synthesised narratively and effect direction plots produced for each outcome. Results: Thirteen studies were included. Social prescribing interventions were evaluated in ten studies, collaborative care in two studies and a new model of care in one study. Positive results (based on effect direction) were reported for the impact of the interventions on wellbeing in socioeconomically deprived groups. Inconsistent (mainly positive) results were reported for anxiety and depression. One study reported that people from the least compared to the most deprived group benefitted most from these interventions. Overall, study quality was weak. Conclusion: Targeting non-pharmaceutical primary care interventions at socioeconomically deprived areas may help to reduce inequalities in mental health outcomes. However, only tentative conclusions can be drawn from the evidence in this review and more robust research is required.

Common mental health disorders (CMDs) disproportionately affect people experiencing socioeconomic disadvantage. Non-pharmaceutical interventions, such as ‘social prescribing’ and new models of care and clinical practice, are becoming increasingly prevalent in primary care. However, little is known about how these interventions work and their impact on socioeconomic inequalities in health. Focusing on people experiencing socioeconomic disadvantage, this systematic review aims to: (1) explore the mechanisms by which non-pharmaceutical primary care interventions impact CMD-related health outcomes and inequalities; (2) identify the barriers to, and facilitators of, their implementation in primary care. This study is a systematic review of qualitative studies. Six bibliographic databases were searched (Medline, ASSIA, CINAHL, Embase, PsycInfo and Scopus) and additional grey literature sources were screened. The included studies were thematically analysed. Twenty-two studies were included, and three themes were identified: (1) agency; (2) social connections; (3) socioeconomic environment. The interventions were experienced as being positive for mental health when people felt a sense of agency and social connection. The barriers to effectiveness and engagement included socioeconomic deprivation and underfunding of community sector organisations. If non-pharmaceutical primary care interventions for CMDs are to avoid widening health inequalities, key socioeconomic barriers to their accessibility and implementation must be addressed.

AimsMedicine reconciliation in community teams is guided by trust guidance, which emphasises that for all new patients accepted into a community team, staff should be aware of all current medication (both psychotropic medication and those prescribed for physical health needs). This information needs to be considered at each review to inform safe prescribing. Upon this background, concordance between electronic mental health records and general practice shared records of medications and allergy status for patients residing at a community forensic supported accommodation was audited in order to identify areas for improvement in practice.MethodsData were collected from mental health electronic records (Rio) and general practice records (Health Information Exchange). All patients residing full-time at a community forensic supported accommodation in Cumbria Northumberland Tyne and Wear NHS Foundation Trust during January 2022 were included. Concordance between the records in medication and allergy status was assessed. Initial assessment was performed by one reviewer and 100% of included records were then cross checked by a second reviewer. Data collection was intended to pick up any mismatch in the records. Standards were set at 100% concordance.ResultsEight patients were included. For allergy status, in two patients’ (25%) records showed allergies which were present in electronic mental health records were not present in general practice records. The reasons as to lack of documentation of allergy status in general practice records were unclear. Cross check of the discharge summaries to primary care from the wards where allergies were originally identified indicates that allergies were clearly documented.For medication, discrepancies between records were found in two patients (25%). In these patients, medications present on general practice records were not present on mental health records. These were both physical health medications (vitamin D supplements) which were being prescribed regularly by primary care and had been omitted during transcription onto electronic mental health records.Conclusion1) Currently, standard practice is for updates of medication on mental health records to take place every four months as part of quarterly care coordination reviews. Electronic mental health records should not be relied upon solely to check patients’ medication: while they provide a snapshot, cross checking with primary care records and pharmacy remains a must. This is current practice and ensures patient safety.2) Primary care to be made aware of the omissions and requested to update their records as per the discharge summaries.3) Continue regular re-audits every four months