GPs in England Express Concerns Over Mental Health Diagnosis
Hundreds of general practitioners (GPs) across England have raised concerns about the over-diagnosis of mental health problems by family doctors. Many GPs admitted to routinely prescribing medication, but they believe that society is over medicalizing the normal stresses of life. A common theme among their comments during a BBC investigation into their experiences with mental health care was the idea that “life being stressful is not an illness.”
One GP warned that labeling emotional difficulties as conditions like anxiety or depression can lead to over medicalization and take resources away from patients with more severe needs. Another commented, “As a society, we seem to have forgotten that life can be tough – a broken heart or grief is painful and normal, and we have to learn to cope.”
The investigation found that nearly 60% of doctors surveyed—442 out of 752 GPs who responded—believed over-diagnosis was a concern. GPs often prescribe medication because they worry that patients will not receive other forms of help, such as talking therapies, quickly enough.
“I find myself regularly reaching for antidepressants, which I know may only help short term and won’t help prevent recurrence,” one GP said. Dr. Adrian Hayter from the Royal College of General Practitioners agreed that there is often pressure from patients on doctors to diagnose them with a mental health condition and prescribe drugs to get them out of the room.
Dr. Hayter, the college’s Medical Director for Clinical Policy, told BBC Radio 4’s Today programme that it takes time for a “proper diagnosis” of conditions like depression. “As a profession, we need to hold on to the values and professionalism we have as GPs – for me, it is that finding a pathway of care and creating the right diagnosis.”
The findings came as Health Secretary Wes Streeting launched an independent review into mental health, ADHD, and autism services amid a mental health crisis. The number of people diagnosed with these conditions has been rising sharply.
In the research, doctors also expressed concerns about the difficulty in accessing mental health help for patients. 67% of participants—508 out of 752—said there was rarely or never enough good quality mental health help available for adults in their area.
A minority of GPs who responded (81 out of 752) felt that mental health problems were under-diagnosed. Meanwhile, some GPs were strongly critical of certain patients, with one describing them as “dishonest, narcissistic… gaming a system free at point of use.”
According to a survey by NHS England, one in five adults in England reports having a common mental health condition, such as anxiety or depression. Rates are even higher among young people, with one in four of 16-24 year olds affected. It is also estimated that 2.5 million people in England have neurodevelopmental conditions like ADHD, including those without a diagnosis. Some NHS services for ADHD are unable to take new patients due to high demand.
GPs identified 19-34 year olds as the age group needing the most support with mental health issues, and 640 GPs (85% of those surveyed) said they were worried about getting young patients the help they needed. One GP noted that young adults “seem to be less resilient since Covid,” suggesting they are more concerned with getting a diagnosis than finding coping strategies.
GPs, all of whom had been in the job for at least five years, reported spending more time on mental health issues. Earlier this year, Wes Streeting suggested that mental health conditions were over-diagnosed and that too many people were being “written off.” He later backtracked, saying his comments were “divisive” and that he failed to capture the complexity of the issue.
One GP called mental health support “a national tragedy.” Another said, “A child literally needs to be holding a knife to be taken seriously and the second that knife is put down, services disengage.”
Professor Victoria Tzortziou Brown, chair of the Royal College of GPs, emphasized the difficult balance GPs face when patients expect a diagnosis for mental health problems but do not meet the criteria. “We must be careful, as a society, not to medicalize the full range of normal feelings and behaviours and ensure GPs are not pressured into making diagnoses that conflict with their clinical judgment,” she said. “But equally, we must avoid dismissing genuine mental health concerns as ‘over-diagnosis’ which risks discouraging people from seeking help.”
Key Questions Raised
- Is the UK facing a prescription madness with one in six adults on antidepressants amidst GP appointment pressures?
- Is ADHD overdiagnosed in the UK, potentially masking depression and triggering concern among top psychologists?
- Is Britain’s surge in self-diagnosed mental health concerns causing a strain on the NHS due to the inappropriate use of psychiatric terms?
- Are young Brits being scandalously neglected as mental health referrals hit alarming crisis levels?
- Are mental health charities too quick to label everyday stress as ‘mental health issues’ and is this creating a crisis in NHS resources?