GPs Struggle to refer patients for Mental Health Services

A survey has found that two thirds of GPs are providing specialist mental health support and struggling to secure help for patients.

A Pulse survey of over 500 GPs found that 70% said they were providing mental health support outside of their competence to children, and 63% said the same for adults.

Many struggled to get children seen by specialist Child and Adolescent Mental Health Services (CAMHS), with one South-East London GP saying they hadn’t had a referral accepted for the last two years, all rejected as ‘not actively suicidal, discharged to GP’.

The survey asked GPs about the impact of the Covid-19 pandemic on mental health services. Among the types of support GPs said they were having to provide were:

  • Adults with suicidal thoughts (86%)
  • mental health crises in adult patients (81%)
  • Monitoring patients who should be monitored by a specialist team (70%)
  • Diagnosing children and adolescents with mental health issues (69%)
  • Children with suicidal thoughts (66%)

Many GPs were needing to give a variety of support during their appointments with patients, according to the Pulse snapshot poll of 569 family doctors. Suicide prevention in adults (86 percent), mental health crises (81 percent), and patient monitoring by a specialist team were among them (70 percent ).

GPs diagnosed mental health difficulties in children and adolescents in 69 percent of cases, and dealt with suicide ideation in children in 66 percent of cases. During the pandemic, 70% of clinicians claimed their local NHS trust raised the referral thresholds for adult mental health referrals, making it more difficult for individuals to get the help they need.

The survey also found that one in 10 respondents said they have to initiate antidepressants for children and young people at least once a month due to a lack of options.

The survey highlighted the rise in mental health issues seen during the pandemic, with GPs reporting that around 38% of consultations now have a mental health element, compared to 25% pre-Covid.

At the same time, access to services has become more difficult:

  • more than half (56%) of respondents said their local trust had unofficially raised the thresholds for adult mental health referrals during the pandemic; and
  • 14% said this had been done officially.

The numbers were similar for CAMHS:

  • 17% of GPs said their local trust had employed official policy to increase the thresholds; while
  • 49% said this had been done unofficially.

According to Pulse, several speciality services, such as ADHD and autism examinations for adults and children, have wait periods of more than 18 months.

NHS England is presently drafting a strategy for mental health waiting times that includes a 24-hour target for urgent mental health care, which will be subject to government approval.

Health professionals have also been asked to provide testimony in support of the government's new 10-year mental health strategy, which seeks to minimise the number of individuals who acquire mental health issues.


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