Across the country, GPs are witnessing a surge in mental health issues. It's time to deal with the root causes, writes Dr Joe McManners.
Dr Joe McManners is a full time GP, and an Oxford City Councillor.
‘Protect the NHS’. The fear of our health services being swamped by the waves of Covid-19 motivated us to stay at home, sacrificing freedom and jobs. The price many have paid for this is their mental health and wellbeing.
Data shows that last year depression rates doubled and waiting times for mental health services, already poor before the pandemic, have rocketed – causing what has been termed ‘the mental health pandemic’. Those dealing with disasters will tell you, the aftermath is often worse than the explosion.
I see the evidence of this every day in my GP surgery. I say ‘surgery’, but a GP day now is unrecognisable to the traditional morning surgery, having undergone a metamorphosis last March. It is now a mash up of phone calls, online dialogue, video conferences and face to face appointments.
A common theme though is the smorgasbord of problems that can be traced back to the mental health of the population. For example, out of 40 direct patient contacts in a day around 15 of them will be directly or indirectly related to the psychological or the psychiatric. This is increasing.
The problems that patients seek help for do not obviously come labelled that way. There will be a few reviews of depression, usually a phone call check that the progress is in the right direction. There will also be the serious mental illnesses and crises including overdoses and psychosis. But there are also many more where the reason for the call is not so obviously originating from someone’s mental wellbeing.
There is the young nurse with unexplained physical symptoms: fatigue, hair loss and pain. Or the concerned call from a wife about her husband who has developed an anger problem and doesn’t seem to be coping. Next, the late middle-aged man with uncontrolled blood pressure who has been drinking to excess.
There is the teenager too anxious to leave the house, waiting months for some support. And then there are the multiple messages from people in distress waiting for services, and the seemingly endless calls from people being denied benefits.
It feels like we are putting sticking plasters over the failings of society and government. The problems people experiencing are often not health problems, but they come to us in the absence of an alternative. Pills and therapy ate not enough. People need houses, decent jobs, decent income, friends and more.
Talking to colleagues across primary care and hospitals, this experience is universal. The NHS is at risk of being overwhelmed by this, the staff in the NHS are at risk of feeling overwhelmed.
The government has announced a £500 million mental health recovery plan. Whilst welcome, this is a drop in the ocean.
Mental health services were already struggling pre-pandemic and will need a lot more to get back on track. It will need more than traditional health services to deal with this problem. Most people I see will not get anywhere near psychiatric teams or inpatients, and hopefully won’t need medication. What they do need is for their problems to be dealt with, and to have a sympathetic ear and a helping hand to fix those problems.
If we look at what we have done well over the last year, the initial social response to lockdown – supporting each other and the vulnerable, and the vaccination programme, the common themes are that the whole country got behind this. A shared national mission meant that volunteers, councils, charities, neighbours all chipped in.
The NHS cannot do this alone. We protected the NHS during Covid waves – but if we want to help the NHS during the recovery, we need the nation to get behind the mental health recovery.
Everyone can do their bit; we need a lot more resources prioritised to services; we need friends, neighbours, volunteers all to help. We need to hold government (local and national) to account and make sure they start to fix the causes of these problems and fix them quickly. Otherwise, this new wave will overwhelm us.
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