I remember sitting there, my hands trembling as I clasped the armrest of the chair that I sat on. Sitting opposite to me was the doctor. A expression of neutrality seemed to be a permanent fixture on her face. Her hair was neatly combed, her mascara applied with meticulous precision and she was impeccably dressed from head to toe; not an inch of her was out of place. I was almost envious considering my own less than majestic image.
Her eyes darted habitually back and forth between the overtly anxious person sitting in front of her and the computer that separated us; she did not betray a flicker of emotion the whole time I was there.
Trying to sum up the world of pain that engulfs you on a daily basis in such a short space of time is not easy. Believe me, I know. In the end, you just have to tell your story, and then await their judgement.
Yet there is always a part of you that wants to shout, to scream. You want them to understand . You need them to understand.
Unfortunately, like many of you out there, I have walked away after seeing a doctor feeling cheated, dejected and most tellingly of all, hopelessly depressed.
It’s the same story all over…
Sadly it is no secret that GPs nationwide lack the necessary knowledge and resources to effectively deal with the mental health crisis that has gripped society.
None of this is a big secret. In fact, much of this comes from the people who work in the profession themselves. In a recent article, a GP revealed that ‘every day I see around two patients with severe mental health problems who I can’t get any help’, and even more significantly, she adds, ‘I have not trained in mental health’.
This is almost hard to believe. It infers that despite the worrying statistics there are out there surrounding the subject of mental illness, the people who supposed to be caring for us are not even competently educated on the subject. This ignorance is not only harming the psychological health of many, but it is killing people.
Every. Single. Day.
The ramifications of this are particularly severe considering a recent report conducted in Canada, another industrialised nation. It is estimated that ‘at least 20% of GP visits were MD-related’, while highlighting that while doctors were comfortable with handling moderate mental disorders, the same could not be said for treating those who suffer with more severe mental issues; patients who were diagnosed with illnesses such as a ‘personality disorder, attention deficit hyperactivity disorder (ADHD), eating disorder, sexual addiction and concomitant substance abuse or mental retardation’ were deemed a challenge. Some GPs even went as far as to admit they were only comfortable in working with these patients when they ‘were stabilised or when more specialised diagnoses were made’.
It is also worth considering that while 25% of all patients who go to their GP for consultation are there to discuss mental health issues they are disallowed from fully explaining their issues due to time constraints. In fact, they are allowed only a mere 10 minutes to discuss their problem. This makes it completely impossible (or at least, highly improbable) that a visit to the GP is sufficient enough to be of any real assistance, outside of prescribing medication or being given direction towards ridiculously oversubscribed therapy services.
In turn, this introduces another flaw, which is that the health service is ‘designed around hospital and medicines rather than identifying and treating psychological disorders’. This, in my honest opinion, the heart of the issue being discussed. Is every potential option exhausted before a GP prescribes a patient antidepressants? What about therapy, meditation, diet, exercise and the myriad of other helpful solutions which can at least help ease the symptoms of mild to moderate depression?
If the latest reports that prescriptions for antidepressants have doubled in the last decade are true , then this is not only extremely worrying, but it would seem to suggest that they are being too readily handed out. Potentially you could argue that as the mental health crisis is worsening this is why the number of patients being given medication have also increased.Yet the point still stands – how likely is it that every single one of these people required this type of medication to stabilise their illness? Not all them – I feel like I can say that with absolute confidence.
If GPs are not able to sufficiently help the mentally afflicted, then who is left to pick up the pieces?
Unfortunately, if the mental health services are not there to handle the fallout of those who suffer with severe mental disorders, then another section of society has to take their place. Who is your first port of call when there is an emergency? You’ve guessed it. The police – and their ability to respond to genuine emergencies is being put under considerable strain as a result.
It is estimated that UK police are spending as much as 40% of their time dealing with incidents related to mental health problems. A report by the Revolving Doors Agency and the Transition to Adulthood Alliance details how ‘84% of all control room calls are related to non-crime incidents, often linked to issues of vulnerability, public protection and safeguarding’. If all of this is true, can you imagine how many crimes occur that go unpunished? More significantly, by dialling 999 rather than another emergency number for apt for the concern at hand, you are adding to the stigma that mentally ill are in some way a threat to you – in the vast majority of cases this is an incorrect assumption.
Another disturbing article suggests that, instead of placing the mentally distressed in environments suitable to their needs, it is often the result that ‘thousands of vulnerable people, even as young as 16, have ended up in police cells as a ‘place of safety’. Even if you can ignore the traumatising nature of confining someone who is mentally ill in a small and unwelcome space, is this really an acceptable way to treat people who clearly need support as opposed to isolation? Maybe if that person demonstrated displays of violence towards others this would be an understandable course of action to take, but as this is unlikely to be the case, I would deem it morally dubious at best.
A silver lining?
While all of this information paints a bleak picture of mental health services in the UK, it would be unfair and inaccurate to ignore the fact that there is work being done in an attempt to overhaul a dated, and thus inefficient system:
-A pilot project aimed at helping to improve GPs understanding the signs of mental health carried out in 2013 resulted in 64% of those trained stating their confidence in dealing with the issue , whereas only 46% were confident in their abilities beforehand.
-More recently, it has been recommended by a task force commissioned by the government that the NHS should train 700 GP mental health specialists and give all GPs basic mental health training by 2020.
– Another report says that GPs and medical students should get more training to help them understand mental illness, particularly with patients who suffer with schizophrenia and psychosis.
-The idea of establishing on site mental healthcare services has also been thrown around as this would free up GPs to spend more time on matters they can confidently deal with, as well as allow them to be more informed about mental health matters in general.
So who is to blame for this crisis?
Pointing fingers at one specific group of people is rarely justified and it is never helpful. So the question therefore is not, are GPs doing enough is help curb the mental health crisis. Instead it is, more often than not, are they being permitted to do enough?
I think the answer in this regard is a firm no. Even doctors with the best of intentions are being limited by the infrastructure of the health service as it currently stands. However, going by what I have mentioned above, there are improvements being tested and, in some cases, carried out. We can only hope that this progress continues and remains unimpeded by government interference and bad decision making by those higher up in the hierarchy.
Another relevant question would be, are we, the general public, doing enough as a society to educate ourselves on mental health issues? While there is little we can do about it unless we’re involved in the profession itself or stage some kind of protest, it is clear that awareness needs to be raised drastically in regards to the subject at hand . We cannot let the stigma dictate how society treats people with mental health problems, and more importantly, we cannot let it play a part in the formation of a fairer, and more flexible health service that treats people with the respect and care they deserve.
What has your experience with your local GP been like? Have they been helpful to you in regards to your mental health issues? Do you have any ideas of your own about how mental health services can be improved either within the UK or your own country of residence? I look forward to reading and replying to your responses in the comment section below!
Emotional support helplines:
Samaritans :116 123
Sane Line:0845 767 8000