This week, GPs are mostly rubbish at mental health.
That seems to be a fairly broad brush criticism, but it came from an exchange between Norman Lamb, health and care minister, and a ‘service user’ at a conference on psychological therapies, so it must be true.
For the sake of balance, I should add that, while Mr Lamb did say that some GPs ‘come out with rubbish’, he also said that some ‘totally get it’.
Well I, for one, don’t. For example, I don’t totally get how he could take at face value the assertion during a Q&A session that GPs don’t take mental problems seriously – the evidence for this being that the aforementioned service user had supposedly been told by a health professional to, ‘Stop watching TV and go for a walk’.
I don’t totally get how he might not try to step back and contextualise that comment by appreciating that a) It was unlikely to have been the sum total of the help given and b) As part of a package of care for – and I’m guessing here – ‘depression’, it’s reasonable advice, given that watching TV during the day would depress anyone, and exercise can be very beneficial, particularly if you’re walking away from the Jeremy Kyle show.
I don’t totally get how he can extrapolate from that to the conclusion that ‘there’s an enormous way to go’ regarding our ‘attitudes towards mental health’, as if we GPs loathe those with ‘bipolar’ or ‘feeling a bit OCD’ any more than the average punter spouting inaccurate, self diagnosed, overblown nonsense.
And I don’t totally get how he doesn’t totally get the irony that, when we’re not being criticised for giving well-meaning/evidence-based lifestyle advice to people with ‘mental problems’ we’re being criticised for prescribing antidepressants unnecessarily, presumably when that lifestyle advice is perceived by the ‘service user’ as not taking the problem seriously enough.
Yes, of course, we’d love to administer some of that de-rigeur talking therapy, but it was around the time I worked out what IAPT stood for that the access to those therapies seemed to vanish.
So: lifestyle advice is rubbish, antidepressants are drugs of Satan, and the queue for CBT starts somewhere over the horizon.
In other words, we GPs are stuck between a rock and a hard place and a rock.
So no, Mr Lamb, I totally don’t get it at all, really. But then, I’m not sure you do, either.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield.
