Harnessing primary care to enhance recovery from severe mental illness
Why this work is in the frame
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Bibliographic record
Abstract
Governments across the English-speaking world have stated that mental health services for people with severe mental illness (SMI) must focus on the redefined notion of recovery. In what has become the seminal definition, Anthony states that: 'Recovery is a way of living a satisfying, hopeful, and contributing life. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of psychiatric disability.' 2 This emphasis on recovery derives from evidence that SMI is not necessarily a lifelong, chronic, and disabling condition. On the contrary, people with SMI can make an excellent recovery. umerous national mental health strategies, including those of England, Canada, and Australia, recommend that GPs and primary health care could and should play a greater role in enhancing recovery. The mental health strategy for England has 'an ambitious aim to mainstream mental health in England', stating that local GP consortia should provide and/or commission high-quality mental health care, as well as taking action to reduce the multiple physical comorbidities frequently afflicting those with SMI. More specifically it states that action should be taken to 'integrate recovery approaches into primary care'. rake and Whitley recently argued that a shift in continuing care from tertiary and secondary care to primary care for people with SMI would be entirely consistent with the philosophical and ethical underpinnings of the recovery paradigm. They contend that recovery by definition involves living an everyday normative life in the community. Hence, separation into specific mental hospitals and ghettoised services is inconsistent with recovery, as it perpetuates segregation and perceived 'difference'. A shift in service delivery towards primary care could thus reduce the social exclusion and stigma frequently felt by people with SMI. Indeed, this is noted in the mental health strategy for England, which acknowledges the 'institutionalised discrimination inherent in many organisations, including support services'.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it