General practice and community services ‘are too overstretched’ to work effectively together to support mental health patients, the BMA has warned.
Its new report, published today and based on doctors’ first-hand accounts, revealed a ‘broken’ system of mental health services in England.
The BMA said that it heard from doctors across the NHS who are in ‘an ongoing struggle to give patients the care they need’ because the funding is ‘just not enough’, there are not enough staff, and the infrastructure and systems are ‘not fit for purpose’.
The report also added that ‘there is sometimes tension between primary and secondary care’, caused by ‘underlying stress’ that patients will not receive the care they need when neither service has the capacity to provide it.
It added: ‘General practice and community mental health services are too overstretched to work effectively together to support patients.
‘Some GPs feel frustrated that their referrals are being rejected, and some psychiatrists working in Community Mental Health Teams (CMHTs) can sense this frustration. The truth is both services are under extreme pressure, with neither at fault.
‘We heard from one GP that mental health cases can be the most challenging, because typically they are enduring and there is less evidence for the efficacy of mental health treatments compared to physical health treatment.
‘In addition, the amount of time it requires to talk sensitively to someone about their mental health is often not possible in a system where GPs are often limited to standard 10-minute appointment times due to a lack of time and capacity given current workload demands.’
The report also pointed out that primary care ‘must not be forgotten’ in any efforts to expand the mental healthcare workforce.
A GP told the BMA: ‘We are holding a lot more risk because unfortunately the mental health services are just not there.
‘They’ve not been there for a long time, they’re in disarray – literally someone has to be about to jump off a building before there is an intervention. And the GP has to manage that.’
Another GP based in Nottingham said: ‘Mental healthcare in this country is dysfunctional. It’s broken.’
BMA mental health lead Dr Andrew Molodynski, a consultant psychiatrist in Oxfordshire, said: ‘We’re having to make hard prioritisation choices that leave many patients without care and support that they urgently need.
‘The demand for mental health services has changed dramatically, but funding has not kept pace.
‘Mental healthcare funding must be based on what people need today, instead of being based on what we spent yesterday, which was inadequate even then.
‘We need these changes to the system to be able provide good quality care and tackle the huge cost of mental health to people’s lives, the NHS, and the economy.’
The report concluded that mental healthcare has not been provided with the funding or staff necessary to achieve the level of improvement needed for patients and the doctors who work within it.
Trying to pinpoint how much extra funding and staff are required ‘is difficult due to a lack of consistent data’ on the prevalence of mental illness in England, it concluded.
An NHS Spokesperson said: ‘NHS Mental health services are seeing record demand with referrals up 30% compared to pre-pandemic, thanks to the hard work of colleagues across the country.
‘The findings of this report highlight there’s still more work to be done, and we remain committed to further expanding access by increasing funding for mental health services by £2.3 billion a year and increasing the number of approved mental health clinicians by 1,000 by 2036/37 through the NHS Long Term Workforce Plan.’
Earlier this month, the Parliamentary and Health Service Ombudsman warned that the safety of mental health patients is being put at risk when they are discharged from inpatient services.
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