mental health



Bringing together physical and mental health

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The LIFT team reports that the ‘least intervention first time’ model, which offers

people direct access, effectively eliminates the waiting lists that occur using the

traditional ‘referral and assessment’ model. Offering an intervention so quickly

removes the risk of ‘downward spirals’ while people wait for assessment or triagebased

treatment. The LIFT team believes that this reduces the need for referrals into

secondary care.

The team also argues that even when the lower-intensity support offered in group

sessions is not sufficient to meet a person’s needs, it can help to speed up escalation

when more severe needs are identified. In response to concerns about providing a

service before conducting an assessment, the team argues that the content of courses

(focused on relaxing, asking for help, managing worrying thoughts) does not carry

any risk of causing harm.

Key enablers


The LIFT service has a long history and a relatively stable workforce; it was

reported that this created high levels of trust so that new services or courses

developed within LIFT would be supported by commissioners and referred into

by local primary care providers.


Positive outcomes from initial piloting of courses for people with long-term

conditions and/or medically unexplained symptoms meant that commissioners

sought to continue providing these courses within the LIFT block contract.


The team has built good working relationships with secondary care mental

health teams.


The lead for long-term conditions spends three days per week working with

patients in the local acute general hospital, giving the LIFT team a direct link

with hospital services as well as general practice.

Further information


Dr Jon Freeman, Clinical Psychologist, LIFT Psychology. Email: jon.freeman@

Appendices: case study site profiles 91

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