Inadequacy of mental health services ‘a ticking time bomb’ say GPs

Most GPs believe mental health services for young people are inadequate, with almost 9 in 10 fearing that children or teenagers may come to harm while waiting for specialist treatment, new research shows.

A survey of 302 GPs for stem4, a charity that works to prevent mental ill health in teenagers, found that 78% of GPs are seeing more young patients with mental health problems than 5 years ago, and 87% expect pressure on services to increase in the years to come. 

Nearly all (97%) of the doctors surveyed had seen a patient aged 11-18 experiencing from depression over the past 5 years. The same number said they had seen a patient experiencing self-harm, and 61% were seeing more young patients self-harming than 5 years ago. 

However, half said they had received no specialist training on self-harm and 36% said they had received training but it was not adequate for them to feel confident supporting young patients.

Stem4’s report, A Time Bomb Waiting to Explode, paints a picture of patchy and underfunded services hit by shortages of specialists, long waits for treatment, and eligibility criteria so strict that GPs are deterred from making referrals.

Worryingly, GPs are reporting that health and social care services for children with mental health issues are not fit for purpose, with 59% of respondents saying they are inadequate and 26% believing they are extremely inadequate. In addition, 83% said services for young people who self-harm are either inadequate or extremely inadequate.

As well as the inadequacy of services, the length of time that children and young people have to spend waiting for treatment is a concern, with 86% of GPs worrying about patients coming to harm before they see a mental health professional.

Most (76%) GPs want to see increased funding for mental health, and 54% want more specialist training for GPs on young people’s mental health problems.

Dr Nihara Krause, consultant clinical psychologist and founder of stem 4, said: “Young people’s mental health services are at crisis point. GPs are having to cope with the consequences of our failure to focus on prevention, and a lack of access to specialist services. We may not be able to change the world we have created for our young people, but we need to take action to ensure that help is available when they need it. GPs are at the forefront of addressing this crisis and they need far more support.

“The increase in mental ill health among our young people is exacerbated by our trophy culture. They are under enormous pressure to succeed in every way, not only at school where they are constantly tested and graded, but also by endeavouring to gain social cachet by competing to be ‘followed’ and ‘liked’ on social media.”

Dr Faraz Mughal, Royal College of GPs clinical fellow for youth mental health, said: “This report provides a worrying insight into the difficulties currently facing young people who need mental health care – and the issues faced by GPs who are trying to care for them.

“GPs are seeing more and more young patients with mental health problems, and they often present in a different way to adults when experiencing mental illness or distress, but services in the community that they could benefit from are underfunded and this invariably puts general practice under pressure and our patients' safety at risk.

“This report brings home how important it is that family doctors receive appropriate specialist-led training in mental health, that there is more investment in mental health services right across the NHS, and that there is greater integration across health, social care, education and justice services, so that we can deliver the care and support our young patients with mental health problems need and deserve.”