Published: 13/06/2002, Volume II2, No.5809 Page 7

A key part of the government's plan to improve care for patients with mental health problems is in danger of falling behind schedule.

The NHS plan said that 1,000 graduate primary care mental health workers would be employed to help GPs. It also said that by 2004 these would have helped 'more than 300,000 people'.

But so far no new staff have been recruited and the Department of Health says it is currently concentrating on the establishment of training programmes for them.

Funds for their appointments will be available next year but some mental health experts doubt that they will be able to treat anything like the projected numbers by 2004.

'It is unlikely that we will see them working in surgeries before 2004, let alone treating hundreds of thousands of people, ' said Dr Joe Neary, a Royal College ofGPs spokesman with a special interest in mental health.

'They will barely be qualified in 2004. They will be working under close supervision, and there are issues about who is going to supervise them.

'There is also a lack of clarity in my mind about what the concept of a primary care mental health worker means.

'This is a shame, it could bring the whole concept into disrepute.'

National programme manager for mental health workforce development Ian Baguley said training courses were expected to start in September 2003 and last for up to a year.

They would be part-time and the mental health workers would take on a limited clinical caseload while they were being trained.

He said treating 300,000 people was 'not an unreasonable goal. . .

they might not reach that in the first year, but I would have thought they would be approaching that.'

The exact role and responsibilities of the new workers - many of whom are expected to be psychology graduates - will be left to primary care trusts to define, although there will be general guidance issued by the DoH 'in due course'.

The NHS plan originally envisaged that they would be trained in 'brief therapy techniques of proven effectiveness' and would treat both adults and children.

Other issues under consideration include how the new workers will be integrated with existing mental health services.

To attract psychology graduates, the new posts will also need to offer a career pathway, which may need to be at a strategic health authority level or above as the average PCT will have only three graduate mental health workers.

The DoH was unable to comment on the likely numbers of people who would be treated by 2004.