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Table 1 Describing a flipped model of mental health care

From: Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention

The AIW Health approach to understanding and addressing mental health need flips the traditional medical model on its head. Current UK medical mental health care starts with a health professional assessing whether an individual meets diagnostic criteria for mental illness. Appropriate medical treatment is initiated, and the individual may also be referred on, if appropriate, for help with practical concerns that might limit healing, for example debt advice. In terms of a biopsychosocial model of care, it is the ‘biopsycho’ element that is dominant, with ‘psychosocial’ components seen as a backup.
Care at AIW Health takes the reverse approach. Care starts with a non-biomedical, whole person assessment of experiences of distress undertaken by an AiW case worker. Practitioner and patient work to identify and address the practical and social issues contributing to distress. Only if mental health issues remain is a biomedical approach employed (through referral on to NHS care). Service users and members of the public have both reported that the psychosocial-dominant AIW Health approach describes a service they would want to use. It provides a service that addresses their needs (recognition), works with them to deal with problems (reciprocity), and leaves them better able to manage issues in the future (resilience). (See http://www.primarycarehub.org.uk/projects/bounceback) Anecdotal evidence from the charity therefore suggests that this ‘flipped’ approach [25] could address the highlighted concerns about access and inequalities.