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

E-Mail: linda.gask@manchester.ac.uk

Harkness-Related Publications

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.