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Independents' Day

GPs accused of referring 'too many' patients to child mental health services

GPs are referring too many patients to child and adolescent mental health services (CAMHS), according to a new report.

Think-tank Localis, whose report was backed by former health minister Norman Lamb, said this was putting unnecessary pressure on an already 'oversubscribed' service.

The report suggested that this is because GP training programmes do not include a sufficient focus on mental health, with just 46% of GP trainees training in a mental health setting at all, and the majority in a secondary care setting.

The report said: 'This means that GPs can lack an understanding of  the best methods to deal with the mental health difficulties of young people.

'This results in a tendency to refer too many onto specialist CAMHS even when they do not meet the criteria for these services, building inappropriate demand into the system and putting unnecessary further pressure on CAMHS.'

In response, the think-tank urged NHS England to 'accelerate' plans to place 3,000 mental health therapists in a general practice setting.

It also said there should be improved mental health training for GPs, echoing calls made previously by the RCGP and backed in part by the last Government.

The report said: 'Given GPs are the main "connectors" to specialist CAMHS, they need to be provided with the tools to increase their confidence levels in appropriately tackling mental health needs of the young people they see.'

It also suggested that teachers should have 'mandatory' mental health training, as in many cases teachers send children to see a GP when they could be referred directly to CAMHS.

It comes as a Pulse investigation, also cited in the think-tank's report, revealed that almost two-thirds of GP referrals to CAMHS lead to no treatment.

Mr Lamb, the Liberal Democrats' health spokesperson, said: 'This is a timely and highly welcome report, at a time when mental health care for children and young people is in a state of crisis in many areas.

'The simple fact is that most young people experiencing a mental health problem still do not receive the timely support they need. Too often they are left waiting interminably or are denied effective support due to high eligibility thresholds.’


Readers' comments (12)

  • Here's the problem.
    No one knows what the boundaries of "mental health issues " are
    Endless awareness campaigns and "motherhood " statements from celebrities create a mushroom cloud of of mental health issues out there all seeking a mental health consultation.
    If the mental health issue in question when looked at closely is simply normality and normal life experience then it cannot be treated
    Does anyone give a toss that the population are referring themselves too much to GPs?

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  • Alternative view is that MH services are underfunded for the workload that is there - that includes PD Functional illness MH associated with physical illness ie those that make up the majority of frequent attenders both in Primary and secondary care.....NHS having MH workers in primary care wont help as they wont see children...worth also saying that we did up to a few years ago have MH Workers in practice

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  • I constantly battle with parents who want their children referred for the normal sulky, sullen teenage behaviour of puberty.

    I have ten minutes a patient, so if it cannot be dealt with by simple reassurance, I refer. What else do you expect ?

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  • Amazing!
    90% of referrals to CAMHS, even many of those with symptoms of anxiety & depression, after declined or sent to someone else. Self harming going through the roof.
    Stop blaming GPs for referrals & develop proper children's mental health services to meet the needs of the current generation

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  • CAMHS is underfunded. But also as a GP you simply cannot reassure the normal patients / parents and even simple basic life experiences are now 'depression' or 'anxious' and they want a referral and medication right NOW.

    The pervasive shit life syndrome / depressed because somebody said BOO which is so prevalent in adult society now has invaded childhood and the result is an explosion of 'mental health consultations' which needn't even happen.

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  • So they still need "timely support" but just don't refer to CAMHS......WTF.....there isn't any other service!!! Just more GP bashing rather than dealing with the real issues.

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  • There are many more things that GPs could do in primary care if they had the time and the incentives. So two things would decrease the referrals to CAMHS, firstly no more than 1000 patients per GP and secondly payment per consultation. This is the case in most places in the world. So why is the UK different to everywhere else?

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  • 2 things, eating disorder services locally for the young recently dropped their criteria to be seen from a BMI of 17 down to 16, Suddenly GP now to sort and manage everyone over 16.1. Great service that, seem to be ignoring the fact that more kids are getting unwell or admitting to it now.But keep on cutting and dumping them on insufficient GP services.
    2. Our local CAMHS are rejecting referrals from local Paediatric Consultants now too. Patient is then sent to GP to sort...
    Why is there is a recruitment crisis. Such a fulfilling and satisfying career now.

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  • Too often they are left waiting interminably or are denied effective support due to high eligibility thresholds.’

    How is that our fault??!! Invest in a proper CAMHS service. Sorted.

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  • AlanAlmond

    This isn't caused by ignorant GPs who need more training. This is the result of near hysterical levels of societal worry about 'mental health issues' in the young. It's almost as if someone is pouring money into advertising mental health problems as todays 'must have' problem. Self harm is rocketing ..why? partly because it's almost being actively pushed as an idea. The result is parents bringing in mildly depressed moody adolescents demanding 'something is done' all on the back of the latest thing they saw on TV. You are almost forced to refer and ..suprise surprise ..nothing much is done (cause there's not much needed ) but this is interpreted as 'a crisis in mental health support' Much of this is medicalising normality and/or actively encouraging maladaptive behaviour in impressionable young people. Don't blame GPs..this is a societal issue and not driven by poor training in general practice. We increasingly simply reflect what people demand. And the latest thing is child mental health's currently a top government priority ...everyone is obsessing about it.. I find it all a little sick to honest..but then I think Facebook is sick too ..maybe I need a referral to child mental health myself ? I'll scratch my arms and go see my GP tomorrow

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