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GPs 'biased' on age, race and sex' over mental health

Many GPs are racist, ageist and sexist in their decisions to refer patients with mental health problems, research has concluded. The study of 32 GPs found 'young, attractive, verbal, intelligent and sociable' patients were most likely to be referred.

Some 38 per cent of the GPs in south London would only refer young people for any psychological treatment, the study, presented to the recent Society for Academic Primary Care conference, found.

A further 34 per cent said they would not refer Afro-Caribbean, Asian or African patients because they would 'resist the concept of psychological illness' or avoid discussing it.

A quarter of GPs would

only refer 'intelligent' patients with clear psychological disorders, where there was no history of psychosis and there would be no language difficulties. GPs also gave 'significantly more' males drug therapy or referred them for psychiatric rather than psychological treatment.

Researchers questioned the GPs on the factors they considered when assessing patients for a psychological referral and gave them casenotes for previously referred patients in which the age, sex and ethnicity of patients was altered.

Lead author Dr Kevin Wright, a counselling psychologist based in general practice and a primary care researcher at the University of Abertay Dundee, said he was 'shocked, to say the least' by the results.

'When we gave GPs open questions on what they would base referrals, it was quite blatant in some cases they would only refer white females and they had to be affluent, fulfilling all the stereotypes,' he said. 'It didn't matter whether the doctors were white or black.'

Older patients were not referred because GPs thought they were 'too fixed in their perceptions' to benefit from treatment, he said.

RCGP mental health lead Dr Huw Lloyd believed the findings raised genuine concerns and said GPs may need more than the standard three months' psychiatry training.

He said: 'Referring patients to other services relies on the ability of the GP to make an appropriate decision.'

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