One in three say mental health deteriorates while waiting for GP appointment
We need to ensure GPs have the right support and training, and that services have sufficient funding, to provide high-quality, timely and appropriate care to those of us experiencing mental health problems, says Mind.
Booking a GP appointment for your mental health is difficult, takes too long and risks making your mental health worse, according to research by the mental health charity Mind and independent research charity Picker*. The major new survey of more than 8,000 people trying to access GP services for their mental health revealed:
- One in three (33 per cent) of people had to wait six days or more for their most recent appointment, usually because it was the first appointment available.
- Almost half (44 per cent) of those who had to wait said they waited longer than expected and a third (32 per cent) said their mental health got worse in the meantime.
- More than one in ten (12 per cent) people surveyed have wanted to see their GP or a practice nurse about their mental health in the past year, but haven’t been able to.
The overwhelming majority of GP appointments are booked over the phone or in person. Mind’s survey found that when trying to book an appointment half of people (47 per cent) were asked to provide a reason for why they needed to see someone. Of those, two in three (65 per cent) weren’t comfortable saying it was for their mental health. More than half (54 per cent) of all respondents said they would prefer online booking yet only a quarter (25 per cent) of these were able to. Research by Citizen’s Advice** shows that awareness of online booking facilities is low.
More than 1 in 10 people surveyed have wanted to see their GP or a practice nurse about their mental health in the past year, but haven’t. The main reason for this was people’s previous poor experience of the service, with a quarter (25 per cent) saying they had put off going again. One in six (14 per cent) weren’t sure if the GP surgery was the right place to get help, more than one in ten (12 per cent) said they didn’t think they would get an appointment in time and almost one in five (17 per cent) were worried about what healthcare professionals would think.
The survey of over 8,000 people in England and Wales also found that people had a better experience of care provided by voluntary organisations than GP services. Young people and those experiencing severe and enduring mental health problems had the worst experiences of care overall. A large proportion of mental health service users also have a long-term physical health condition but less than half felt able to discuss their physical health at the same time as their mental health.
Separate research by Mind found that 40 per cent of all GP appointments involve mental health and that demand is rising. Beyond Mind, no other organisation routinely surveys people about their experiences of primary care support for mental health.
Paul Farmer, Chief Executive of Mind, the mental health charity, said:
“It’s unacceptable that so many people are struggling to access the support they need from their GPs, when they need it. We know that there are many barriers to people seeking help from their GP in the first place, but on top of this we are concerned that problems with booking appointments may deter people further. When people do manage to see their GP, experiences are mixed, and young people in particular seem to have much worse experiences of care.
“GP’s do a hugely important job under immense pressure. Most people accessing support for their mental health will only be seen by their GP, so we need to ensure GPs have the right support and training, and that services have sufficient funding, to provide high-quality, timely and appropriate care to those of us experiencing mental health problems.
“This is the first survey of its kind on this scale. Since GPs are the first port of call for most people seeking help for their mental health, we wanted to understand people’s experiences of primary care. It is a critical time for mental health care and the most important evidence of whether things are improving is in people’s experiences. We will be running this survey every year so that we can monitor whether services really are improving and using the data to hold services to account.”
Sophie Edwards, 21-year-old from Kent said:
“I was always a worrier and would often overthink a lot of unnecessary things, but it was only once I started university three years ago that I felt I really needed help. I put so much pressure on myself to do well. I would wake up fighting a daily battle where my brain repeatedly tells you you’re not good enough, leaving you feel exhausted all the time.
“My first GP appointment, was not helpful at all - I was brushed off and handed a leaflet. I had to go back several times to get the help and support I needed - begging to be referred for cognitive behavioural therapy. After finally being deemed a priority and endless letters from my doctor, I received the call to say my wait was over. During the seven months of uncertainty, my depression got much worse. A lot of things happened in my life, from losing family members to going through a breakup, which all made the waiting and relentless pressure to get the right support even more stressful. I also felt because of the long wait and my depression worsening, my therapy wasn’t really dealing with the aspect of my mental health which I was currently struggling with.
“Depression and anxiety is an ongoing thing, but for me, therapy was a really big part of managing my mental health, I use the techniques I learnt in CBT without even realising. GPs are the gateway to accessing this kind of support. I think it’s really important you are able to see your GP straight away and make those additional appointments when you need them, because it will help prevent a revolving door effect and people can get help for their mental health earlier.”
Stacie-Mai Pemberton, 27-year-old from Swansea said:
“My depression and anxiety has peaked and troughed at various points throughout my life since I was a teenager. Nowadays, it’s often the stresses of everyday life which have the biggest impact on my mental health.
“Two years ago, my mental health got really bad. I had just started a new job with the ambulance service, but became physically ill only a few weeks after starting my new role. I was passed between nurses, doctors and other GP services, trying to find out what was wrong. My GP told me I was fine, so I carried on working but it turned out it was my appendix. I was upset, frustrated and in a lot of pain. This, on top of a new, high pressure job was quite overwhelming. Eventually my appendix was removed, but my own wellbeing had been impacted quite significantly due to the stress of the whole thing.
“I also found trying to access mental health support in my new area really stressful and complicated. Of course, being off work has added to the stress of it all, as my wife needs to work harder than she already does to cover the bills.
“My GP surgery requires you to give the receptionist a reason for the appointment, then they’ll decide whether you are seen that day. I remember ringing asking for my medication to be reviewed because I’d been really struggling - and their response was: ‘you want your antidepressants changed...does that really need to be done today as we are short staffed etc and doctors only want to see emergencies or genuine medical conditions.’ It puts me off wanting to book an appointment because I do not want to feel like I’m wasting people’s time. Having worked as a 999 call handler I do not understand why GPs prioritise these ‘life threatening emergencies’ when people should be calling 999.
“There needs to be better systems in place so people with mental health problems feel comfortable when booking appointments, and not fearful they will be judged when seeking help. GP’s are a really important support arm for people experiencing mental health problems.”
The Big Mental Health Survey 2018 can be completed at www.bigmentalhealthsurvey.com
Notes to Editors:
*The Big Mental Health Survey was conducted between July–September 2017, and was completed by 8,339 people with experience of mental health problems. It was promoted via social media channels, and supporter lists of leading mental health charities –including Mind, Rethink Mental Illness, MQ, Centre for Mental Health, and others. Paper questionnaires were distributed by local Minds and Mind retail shops.