Young people seeking GP help for psychiatric symptoms have low ongoing contact

Young people presenting to their GP with psychiatric symptoms have low or falling rates of ongoing contact, according to an analysis by University of Manchester researchers.

If the trajectories seen in the study, which looked at consultations over a five-year period, reflect improvement of symptoms, this could provide some reassurance for children, teenagers and their families, the researchers said.

But the pattern might also reflect an unmet need for some, they added.

They tracked outcomes and contact with healthcare services in a group of 370,000 three to 18-year-olds who had symptoms of a possible psychiatric condition including depression, anxiety, autism or ADHD.

Reporting the findings in Lancet Psychiatry, they said that almost 208,000 (51%) of the children and adolescents who presented with psychological symptoms to their GP had few subsequent healthcare contacts over the next five years.

They were very unlikely to be prescribed medications, or to be referred to specialist services for their mental health, the researchers said.

These children and adolescents – the largest of seven groups identified in the study – also had the lowest risk of future hospitalisation for either self-harm or suicide and were more likely to be younger, male, and from non-White ethnic groups.

Another 13% of children had some ongoing contacts with the GP but were not prescribed medications.

Other groups identified each made up less than 10% of the overall cohort. Only 6.5% of the cohort had prolonged specialist contact. One group defined as prolonged GP contact accounted for 8.6% had the highest proportion of children and adolescents with ADHD symptoms, the researchers said.

Children and adolescents from Black, South Asian, and other non-White ethnicities had lower rates of ongoing GP contact, the researchers found but the study was not able to explain the reasons for the differences which needs more investigation.

While increasing numbers of children are seeking help for mental health symptoms, the results suggest that for most young people, those problems will be transient, or they have received the support they need through non-medical routes.

Study lead Dr Morwenna Senior said the findings suggest that most children and young people with mental health symptoms have low or declining rates of ongoing contact with GPs and specialists.

It fits with previous research which suggests that for many young people, the prognosis is good and symptoms are likely to improve over time.

She added: ‘Though it’s not clear if a proportion of this figure is because children are not receiving the medical support they need, this study can provide some reassurance to parents and children that many, if not most children will get better.

‘It is also reassuring that the children in the low-contact group were the least likely to be hospitalised for self-harm, or to die by suicide.’

More research will be needed to identify whether some children have unmet needs that were not measured by the study and whether they receive further help elsewhere. More detail on this could help inform service provision and preventive practice, Dr Senior added.

‘For children whose problems are likely to resolve, reassurance and psychoeducation may be enough; whereas, for others, more intensive interventions might prevent deterioration in symptoms.

‘We hope that our results will help distinguish these groups and better allocate limited resources.’

A record 1.2 million under-18s were referred to Child and Adolescent Mental Health Services in 2022, figures published last summer show.