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Patients with anxiety visit GP, but those with depression go to A&E, finds study

Patients with anxiety are more likely to visit their GP, while those with depression are associated with higher numbers of A&E visits, analysis of survey data has shown.

Researchers found anxiety was the only mental health condition they looked at that was ‘significantly associated’ with GP attendance, when taking account of other factors such as a person’s socio-economic status and their physical health.

In comparison, depression was the only mental health condition that was significantly associated with emergency department attendance when adjusted for other factors, said the study, published in the British Journal of General Practice.

The research looked at data from a household survey of 2,653 people in the North West of England, which asked people about their use of services in the region in the past 12 months. It asked about four mental health issues – depression, anxiety, paranoia, and hallucinations.

It also found people with mental health conditions are two and a half times more likely to visit their GP than patients with no health conditions, while those with only physical health conditions are 2.4 times more likely to attend their GP practice than patients with no health issues.

Meanwhile, those with both physical and mental health conditions are almost four times more likely to visit their GP practice than people with no health issues.

The paper said: ‘The present study confirms that people with anxiety visit GPs more frequently. The association between anxiety and use of GP services may be due to acute exacerbations of anxiety becoming intolerable so that patients turn to GPs as their first point of support. This is in contrast with severe depression, which is associated with becoming withdrawn from society, particularly for males.

‘Alternatively, severe depression may be viewed as a more urgent concern by carers and relatives because of concerns about the imminent risk of self-harm, which in turn may lead to emergency department visits.’

It added: ‘Another reason for people with anxiety visiting the GP could be mistaking the feeling of acute anxiety for other physical health symptoms prompting increased GP visits where patients are likely to be seen quicker and by doctors they know, therefore reducing further anxiety brought on by the uncertainty of the length of wait and social interaction.’

Study author Dr Pooja Saina, senior lecturer in psychology at the University of Liverpool, said the research suggested more mental health expertise is needed in emergency departments and GP practices.

But she said it also needed to be recognised that social conditions, such as debt, housing and unemployment, cannot be resolved by medical practitioners.

She added: ‘More research is needed into the social attributes that contribute to reduced emergency department and general practice attendance rates.’

Commenting on the study findings, Professor Martin Marshall, chair of the RCGP, said: ‘This research shows that having poor mental health is an indicator that people will attend their GP practice, and emergency departments, more often – and it needs to be taken seriously as we strive to ensure parity between mental health and physical health. This finding will come as no surprise to GPs and their teams.’

He said GPs needed longer appointment times and access to better support services – in the NHS as well as charities in the community – to help patients with mental health problems. 

He added: ‘We also need to see the pledge made in the GP Forward View, for GPs to have access to one of 3,000 mental health therapists in the community, delivered in full and as a matter of urgency.’