Even before the COVID-19 pandemic, GPs were under pressure to deal with rising numbers of patients with mental health concerns. A survey by MIND in 2018 found that 40% of all GP appointments were about mental health.
But COVID-19 and the resulting lockdowns are now taking a further toll on people’s mental health. Since the first national lockdown, GPs have reported seeing more patients with anxiety, depression and trauma symptoms.
So what is the scale of the national mental health problem and could it affect GPs’ own wellbeing?
Mental health during the pandemic
Hundreds of thousands of people in the UK have experienced trauma resulting directly from SARS-CoV-2, such as serious illness and bereavement. Many more have been adversely affected by the ensuing social restrictions and economic fallout, with widespread feelings of anxiety, loneliness and fear for the future.
Studies show deteriorating mental health across all age groups:
- Over half of adults and more than two thirds of young people reported worsening mental health from early April to mid-May 2020 (MIND).
- The proportion of adults with moderate to severe symptoms of depression almost doubled from ~10% in 2019 to 19% in June 2020. For 16–39 year olds that proportion rose from 11% to a worrying 31%.
- One in six children aged 5–16 years were estimated to have probable mental health disorders in 2020 (NHS England).
Now, during the third national lockdown, the situation does not appear to be improving. Levels of personal wellbeing are among the lowest since March 2020.
Which patient groups are most affected?
Research by MIND found that declining mental health was most likely to be reported by:
- People with disabilities
- Those living in social housing
- People with eating disorders, obsessive compulsive disorder, or personality disorders
- Frontline workers.
As lockdown restrictions are slowly eased, we can hope that for many people, mental wellbeing will start to improve. But experience from the UCL COVID-19 social study shows that even after restrictions are lifted, anxiety and depression may remain at higher levels among people in younger age groups, with low incomes, with a diagnosed mental illness, who live with children, or who live in urban areas.
Long-term impacts on health
The mental health impacts of the pandemic are likely to be felt for years to come, with ramifications for declining physical health.
According to MIND, over half of adults and young people are reportedly over or under eating to cope during the pandemic, nearly a third are using alcohol or illegal drugs, and a third of young people with existing mental health problems are self-harming.
Parag Pandya, a GP in Kent, wrote in the British Journal of General Practice: “We as GPs must strive to ensure that the long-term implications on patients’ mental health due to COVID-19 are minimised as much as possible.”
The impact on GPs
GPs are bracing themselves for a flood of untreated mental illness. Many are already experiencing this challenge. According to Southampton GP and British Medical Association (BMA) council member Alex Freeman, “It’s tough, it’s really tough … We’re seeing people presenting with a lot of anxiety, sometimes with depression.”
Unsurprisingly, the increasing workload is taking its toll on the mental health of GPs too. In October, GPonline revealed that hundreds of GPs have sought mental health support from NHS Practitioner Health, a free and confidential service for doctors and dentists in England.
A BMA survey carried out at the end of last year, including responses from nearly 2,500 GPs, found that nearly half of respondents reported work-related depression, anxiety, stress, burnout, emotional distress or another mental health condition that was worse than before the pandemic. Many were also working extra hours and feeling exhausted.
GPs may also be experiencing heightened anxiety about medico-legal issues when treating patients with mental health problems during the pandemic. Any members who are facing complaints or claims should immediately contact Medical Defense Society for expert advice.
Resources for managing patients’ mental health
The Royal College of General Practitioners helpfully provides a Mental Health Toolkit for healthcare professionals supporting those with mental illness. The resources include trigger questions, diagnostic tools, and current guidance.
In some practices, further help may be on the way in the coming months. From April 2021, all primary care networks will be entitled to use new funding to pay for a mental health practitioner based in general practices (jointly funded by mental health providers).
Looking after GPs’ wellbeing
A wealth of resources can be found online for GPs who need support for their own mental health:
- MindEd: Coronavirus Staff Resilience Hub
- BMA: Sources of support for your wellbeing
- RCN Foundation: Mental health and wellbeing repository.
The expert team at Medical Defense Society is also available 24/7 to help with any complaints, incidents, claims or other legal issues that members may be faced with due to treating patients with mental health problems.