Primary care could be so useful when helping those with mental health problems. GPs, practice nurses and pharmacists are most peoples’ first point of contact and if that care was spot on then it would have a significant and positive effect on patients. Unfortunately there are a lot of difficulties with primary care and it is very much a post code lottery as to the quality of care a person receives.
When a patient breaks a leg they are classed as an emergency and get treatment on that day but when someone’s mind breaks they are often left untreated for a very lengthy wait whilst the mind becomes more and more damaged. The first difficulty with primary care is access. It can be very difficult to access a primary care professional because of the wait for an appointment, in some parts of the UK there is a 6 week wait at a GP surgery. It can be particularly difficult for certain groups to access a GP surgery such as those that are homeless and haven’t got an address to register and the same with young people who may move around a lot due to being a student and therefore have to keep registering with services. Young people may also not have the confidence to book an appointment and go along to the surgery.
Once a patient has made an appointment with a GP then the appointment itself has difficulties, for example the consultation can feel quite rushed if the GP is running late and the patient may not feel listened to or understood. I have found that my GP has been quite dismissive, particularly as I have an eating disorder. Any symptom I have is automatically connected to my eating disorder but actually it is possible to have a mental illness AND a physical illness.
Sometimes the patient may not feel that they have a lot of choice in their treatment, for example if their GP is only offering them medication and not talking therapy then the patient may not feel they have any other option. If that patient does get a referral to a service such as IAPT then the waiting times are yet another difficulty. Some people have waited 18 months with very little support from primary care professionals, the waits are so long that people are worrying that they have dropped off of the system. Patients with existing or emergent mental health conditions should not be living in fear of falling through the gaps in the system.
Primary care could be incredibly effective in helping those with mental health problems. It could provide early intervention and help people before the illness turns into a long term health problem or requires inpatient treatment or years of therapy. It could be effective not only in terms of minimising suffering but it could also be financially effective as patients may be able to remain in work and require short-term treatment.