An issue that is regularly brought up by mental health service users, their families and carers is the lack of timely and appropriate services provided by GPs for people who present with mental health problems.
GPs are often the first point of contact for people in this situation and so are well placed to ensure that people receive the right help at the right time. This is particularly the case in areas of social deprivation where the rate of mental health problems in the most deprived areas (30%) is double the rate in the least deprived areas (15%). Unfortunately, as borne out by human rights monitoring conducted by the Mental Health Rights Campaign, too often this is not what happens in practice.
In 2015 58% of people surveyed indicated that waiting times to see GPs were unsatisfactory or very unsatisfactory, while less than half (41%) felt that their GP had offered them the most appropriate type of care.
In response to this the Mental Health Rights Campaign is exploring why these problems exist and what solutions can be developed. During late spring/summer 2016 PPR worked with a number of mental health groups across Northern Ireland to explore in more depth the specific issues that exist with accessing timely and appropriate help from GPs. Workshops were held with various groups including CAUSE carers group in Foyle, STEPS in Draperstown, SAM88 in Cookstown and the Belfast Mental Health Rights Group.
Among the issues raised by people were difficulties getting an initial appointment, difficulties in rural areas with getting an out of hours appointment when experiencing a mental health crisis, lack of privacy in reception areas, not enough time for appointments, lack of expertise among GPs in relation to mental health and no mechanisms for patient participation.
Difficulties with getting an appointment was raised by all groups. The following quote reflects a common experience among service users “In ours (GP practice) from now to the third week you can’t get an appointment because they are all booked up and their books are closed and you can’t make an appointment until the books are open again”
The lack of expertise in relation to mental health was also frequently raised – one group member described their GP’s limited approach to addressing a mental health issue as one of “They go by a list of questions they have to cover”
People felt strongly that among the specific training in relation to mental health that GPs should be required to have undertaken was the Applied Suicide Intervention Skills Training (ASIST).
PPR is now working with groups to explore these issues further and to develop rights based solutions.
Many of the problems identified by patients, their families and carers are readily acknowledged by GPs themselves. A survey commissioned by the Royal College of GPs in 2015 shows that nearly three quarters (72.5%) of adults in Northern Ireland believe that GP waiting times are at crisis level. Two thirds (64.8%) of people surveyed were not able to book an appointment with within the same week. The poll found that patients in Northern Ireland have the longest GP waiting times.
GPs have highlighted the need for a major overhaul of how GP practices deliver services to patients, including people presenting with mental health problems. Among other recommendations put forward to the Health Minister, the British Medical Association has called for primary care teams to be expanded to include mental health practitioners.
The Health Minister’s response to the Bengoa Expert Panel’s recommendations on reform of the Health Service, ‘Health and Wellbeing 2026’, recognised that primary care is the ‘bedrock’ of the health and social care system, providing as it does 95% of the care people need throughout their life. It sets out a commitment to increased investment in GP services with more funding for mental health interventions in primary care. As all the proof of the pudding will be in how this vision is delivered upon.
The next stage of this campaign will involve mental health service users carrying out their own ‘surveys’ of GP practices. The information gathered will be used to develop a set of standards that people are entitled to have met by their GP service and to campaign for their adoption and implementation. One group member described the standard that people should be able to expect as follows ‘If it was just functioning normally, to a standard, never mind a gold standard’.
If you have personally experienced issues in accessing services from your GP for mental health problems and would like to get involved in this campaign please get in contact. It is really important that your voice is heard! Contact Sara on email@example.com or 90 313315.