Harkness Project Title: The Role of the Specialist in Improving the Quality of Care for Depression and Diabetes
Mentors: Michael Von Korff, Sc.D., and Edward H. Wagner, M.D., FACP
Host Institution: Center for Health Studies, Group Health of Puget Sound
Biography at time of Harkness Fellowship: Linda Gask, M.B.Ch.B., a 2000-01 Commonwealth Fund Harkness Fellow in Health Care Policy, is a consultant psychiatrist at the Guild Community Health Care Trust, which is affiliated with the University of Manchester’s Department of Community Psychiatry, and a reader in psychiatry at the National Primary Care Research and Development Centre also at the University of Manchester. There she co-leads research on primary mental health care. Her research has encompassed a broad range of topics that includes the impact of training GPs to manage mental health problems, the evaluation of the impact of Total Purchasing on mental health care provision, tele-psychiatry, and the development of quality indicators for mental health in primary care settings. Gask also trains primary care physicians and other primary care workers in psychiatry. She is a Fellow of the Royal College of Psychiatry and studied medicine at the University of Edinburgh. Her Ph.D. and M.Sc. are also from the University of Edinburgh. Based at Group Health of Puget Sound, her Harkness Fellowship compares treatment and outcomes of mental health problems in primary care in the United States and the United Kingdom.
Project: Gask sought to examine the role of specialists in facilitating quality improvement efforts for patients with diabetes or depression, and the appropriateness of specialists’ acting as agents of change in general. She also examined the optimum balance between primary and specialist care for managing depression and diabetes in the population. She conducted interviews with primary care physicians, mental health specialists, diabetologists, and other key players in a large managed care system.
Career Activity Since Fellowship
- Professor, Primary Care Psychiatry, University of Manchester and Greater West Foundation NHS Trust and Salford CT, 2004
Current Position: Professor of Primary Care Psychiatry, University of Manchester (Updated 1/2014)
Goldberg DP, Gask L, Zakroyeva A, Proselkova E, Ryzhkova N, Williams P. Training teachers to teach mental health skills to staff in primary care settings in a vast, under-populated area. Ment Health Fam Med. 2012 Dec;9(4):219-24.
Reilly S, Planner C, Gask L, Hann M, Knowles S, Druss B, Lester H. Collaborative care approaches for people with severe mental illness. Cochrane Database Syst Rev. 2013 Nov 4;11
Richards DA, Hill JJ, Gask L, Lovell K, Chew-Graham C, Bower P, Cape J, Pilling S, Araya R, Kessler D, Bland JM, Green C, Gilbody S, Lewis G, Manning C, Hughes-Morley A, Barkham M. Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial. BMJ. 2013 Aug 19;347:f4913.
Roberts RG, Gask L, Arndt B, Bower P, Dunbar J, van der Feltz-Cornelis CM, Gunn J, Anderson MI. Depression and diabetes: the role and impact of models of health care systems. J Affect Disord. 2012 Oct;142 Suppl:S80-8.
Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens C, Coventry P. Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev. 2012 Oct 17;10
Gask L, Bower P, Lamb J, Burroughs H, Chew-Graham C, Edwards S, Hibbert D, Kovandžić M, Lovell K, Rogers A, Waheed W, Dowrick C; AMP Research Group. Improving access to psychosocial interventions for common mental health problems in the United Kingdom: narrative review and development of a conceptual model for complex interventions. BMC Health Serv Res. 2012 Aug 13;12:249.
Gask L, Coventry P. Person-centred mental health care: the challenge of implementation. Epidemiol Psychiatr Sci. 2012 Jun;21(2):139-44.
Ellison L, Gask L, Bakerly ND, Roberts J. Meeting the mental health needs of people with chronic obstructive pulmonary disease: a qualitative study. Chronic Illn. 2012 Dec;8(4):308-20.
Bristow K, Edwards S, Funnel E, Fisher L, Gask L, Dowrick C, Chew Graham C. Help Seeking and Access to Primary Care for People from "Hard-to-Reach" Groups with Common Mental Health Problems. Int J Family Med. 2011;2011:490634.
Gask L, Dowrick C, Salmon P, Peters S, Morriss R. Reattribution reconsidered: narrative review and reflections on an educational intervention for medically unexplained symptoms in primary care settings. J Psychosom Res. 2011 Nov;71(5):325-34.
Makin S, Gask L. 'Getting back to normal': the added value of an art-based programme in promoting 'recovery' for common but chronic mental health problems. Chronic Illn. 2012 Mar;8(1):64-75.
Gask L, Macdonald W, Bower P. What is the relationship between diabetes and depression? a qualitative meta-synthesis of patient experience of co-morbidity. Chronic Illn. 2011 Sep;7(3):239-52.
Chew-Graham C, Kovandžić M, Gask L, Burroughs H, Clarke P, Sanderson H, Dowrick C. Why may older people with depression not present to primary care? Messages from secondary analysis of qualitative data. Health Soc Care Community. 2012 Jan;20(1):52-60.
Bower P, Macdonald W, Harkness E, Gask L, Kendrick T, Valderas JM, Dickens C, Blakeman T, Sibbald B. Multimorbidity, service organization and clinical decision making in primary care: a qualitative study. Fam Pract. 2011 Oct;28(5):579-87.
Lamb J, Bower P, Rogers A, Dowrick C, Gask L. Access to mental health in primary care: a qualitative meta-synthesis of evidence from the experience of people from 'hard to reach' groups. Health (London). 2012 Jan;16(1):76-104.
Schofield P, Crosland A, Waheed W, Waquas A, Aseem S, Gask L, Wallace A, Dickens A, Tylee A. Patients' views of antidepressants: from first experiences to becoming expert. Br J Gen Pract. 2011 Apr;61(585):142-8.
Kovandžić M, Chew-Graham C, Reeve J, Edwards S, Peters S, Edge D, Aseem S, Gask L, Dowrick C. Access to primary mental health care for hard-to-reach groups: from 'silent suffering' to 'making it work'. Soc Sci Med. 2011 Mar;72(5):763-72.
Gask L, Khanna T. Ways of working at the interface between primary and specialist mental healthcare. Br J Psychiatry. 2011 Jan;198(1):3-5, sup 1
Asher CJ, Gask L. Reasons for illicit drug use in people with schizophrenia: Qualitative study. BMC Psychiatry. 2010 Nov 22;10:94.
Patel V, Maj M, Flisher AJ, De Silva MJ, Koschorke M, Prince M; WPA Zonal and Member Society Representatives. Reducing the treatment gap for mental disorders: a WPA survey. World Psychiatry. 2010 Oct;9(3):169-76.
Bee PE, Lovell K, Lidbetter N, Easton K, Gask L. You can't get anything perfect: "user perspectives on the delivery of cognitive behavioural therapy by telephone". Soc Sci Med. 2010 Oct;71(7):1308-15.
Mead N, Lester H, Chew-Graham C, Gask L, Bower P. Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis. Br J Psychiatry. 2010 Feb;196(2):96-101.
Dowrick C, Gask L, Edwards S, Aseem S, Bower P, Burroughs H, Catlin A, Chew-Graham C, Clarke P, Gabbay M, Gowers S, Hibbert D, Kovandzic M, Lamb J, Lovell K, Rogers A, Lloyd-Williams M, Waheed W; AMP Group. Researching the mental health needs of hard-to-reach groups: managing multiple sources of evidence. BMC Health Serv Res. 2009 Dec 10;9:226.
Hayes AJ, Shaw JJ, Lever-Green G, Parker D, Gask L. Improvements to suicide prevention training for prison staff in England and Wales. Suicide Life Threat Behav. 2008 Dec;38(6):708-13.
Peters S, Rogers A, Salmon P, Gask L, Dowrick C, Towey M, Clifford R, Morriss R. What do patients choose to tell their doctors? Qualitative analysis of potential barriers to reattributing medically unexplained symptoms. J Gen Intern Med. 2009 Apr;24(4):443-9.
Gask L, Lever-Green G, Hays R. Dissemination and implementation of suicide prevention training in one Scottish region. BMC Health Serv Res. 2008 Dec 3;8:246.
Dowrick C, Gask L, Hughes JG, Charles-Jones H, Hogg JA, Peters S, Salmon P, Rogers AR, Morriss RK. General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study. BMC Fam Pract. 2008 Aug 19;9:46.
Slade M, Gask L, Leese M, McCrone P, Montana C, Powell R, Stewart M, Chew-Graham C. Failure to improve appropriateness of referrals to adult community mental health services--lessons from a multi-site cluster randomized controlled trial. Fam Pract. 2008 Jun;25(3):181-90.
Simpson A, Richards D, Gask L, Hennessy S, Escott D. Patients' experiences of receiving collaborative care for the treatment of depression in the UK: a qualitative investigation. Ment Health Fam Med. 2008 Jun;5(2):95-104.
Gask L, Rogers A, Campbell S, Sheaff R. Beyond the limits of clinical governance? The case of mental health in English primary care. BMC Health Serv Res. 2008 Mar 26;8:63.
Chew-Graham C, Slade M, Montâna C, Stewart M, Gask L. Loss of doctor-to-doctor communication: lessons from the reconfiguration of mental health services in England. J Health Serv Res Policy. 2008 Jan;13(1):6-12.
Fletcher J, Gavin M, Harkness E, Gask L. A collaborative approach to embedding graduate primary care mental health workers in the UK National Health Service. Health Soc Care Community. 2008 Sep;16(5):451-9.
Campbell SM, Gately C, Gask L. Identifying the patient perspective of the quality of mental healthcare for common chronic problems: a qualitative study. Chronic Illn. 2007 Mar;3(1):46-65.
May C, Finch T, Mair F, Ballini L, Dowrick C, Eccles M, Gask L, MacFarlane A, Murray E, Rapley T, Rogers A, Treweek S, Wallace P, Anderson G, Burns J, Heaven B. Understanding the implementation of complex interventions in health care: the normalization process model. BMC Health Serv Res. 2007 Sep 19;7:148.
Chew-Graham C, Slade M, Montana C, Stewart M, Gask L. A qualitative study of referral to community mental health teams in the UK: exploring the rhetoric and the reality. BMC Health Serv Res. 2007 Jul 25;7:117.
Richards DA, Lovell K, Gilbody S, Gask L, Torgerson D, Barkham M, Bland M, Bower P, Lankshear AJ, Simpson A, Fletcher J, Escott D, Hennessy S, Richardson R. Collaborative care for depression in UK primary care: a randomized controlled trial. Psychol Med. 2008 Feb;38(2):279-87.
Salmon P, Peters S, Rogers A, Gask L, Clifford R, Iredale W, Dowrick C, Morriss R. Peering through the barriers in GPs' explanations for declining to participate in research: the role of professional autonomy and the economy of time. Fam Pract. 2007 Jun;24(3):269-75. Epub 2007 May 15.
Salmon P, Peters S, Clifford R, Iredale W, Gask L, Rogers A, Dowrick C, Hughes J, Morriss R. Why do general practitioners decline training to improve management of medically unexplained symptoms? J Gen Intern Med. 2007 May;22(5):565-71.
Gask L. Is depression a chronic illness? For the motion. Chronic Illn. 2005 Jun;1(2):101-6. Review.
Harkness E, Bower P, Gask L, Sibbald B. Retention and future job intentions of graduate primary care mental health workers: a newly developed role in England. J Health Serv Res Policy. 2007 Apr;12 Suppl 1:S1-18-22.
Lester H Gask L “Delivering medical care for patients with serious mental illness or promoting a collaborative model of recovery?” British Journal of Psychiatry 2006, 188:401-2.
Gask L Ludman E Schaefer JA “Qualitative study of an intervention for depression among patients with diabetes: how can we optimize patient-professional interaction?” Chronic Illness 2006. 2 231-42
Sheaff R, Sibbald b, Campbell S, Roland M, Marshall MN, Pickard S, Gask L, Rogers A, Halliwell S. Soft governance and attitudes to clinical quality in English general practice. Journal of Health Services Research and Policy 2004;9:132–138.
Gask L “Powerlessness, control and complexity: the experience of family physicians in a group model HMO.” Annals of Family Medicine 2004 2: 150-5.
Gask L “Role of specialists in common chronic diseases.” BMJ 2005, 19;330: 651-3.
Gask L. “Overt and covert barriers to the integration of primary and specialist mental health care.” Social Science and Medicine 2005 61:1785-94.
Bower P Gask L “The changing nature of consultation-liaison in primary care: bridging the gap between research and practice.” General Hospital Psychiatry 2002. 24:63-70.
Crowther R, Gask L, Ives R, Jakenfelds J. "A program designed to monitor the course and management of depressive illness across the primary/secondary interface," Medinfo–Journal of the American Medical Informatics Association, 2001;10(Pt 1):719–23.