Mental health now a ‘crisis in general practice’

The crisis in mental health has become a crisis in general practice, says the Irish College of General Practitioners.

Mental health now a ‘crisis in general practice’

Dr Brian Osborne, director of the ICGP’s mental health programme, told an Oireachtas committee that GPs are the first port of call for many people experiencing mental health difficulties.

More than 90% of mental health care takes place in a general practice setting — around a third of consultations with family doctors include a “mental health component”.

GPs also provide physical and psychological support to those with lifelong mental health conditions, such as schizophrenia.

Dr Osbourne said GPs are unable to give enough time to patients presenting with mental health problems.

He told a meeting of the joint committee on the future of mental health care that GPs would be unable to care for patients with mental health issues if their situation does not improve.

Dr Osborne called for the reversal of financial emergency (FEMPI) pay cuts imposed during the economic crisis, a new GP contract, and additional funding to expand primary care.

He told the committee the ICGP had consistently raised the crisis in emergency department services and the difficulties experienced in accessing diagnostics for patients needing urgent care.

“It is in the area of mental health, when patients are most vulnerable and most at risk, that the draconian cuts in health funding during the recession had the most tragic effects,” said Dr Osborne.

Dr Brendan O’Shea, director of the ICGP’s Post-graduate Resource Centre, said the time to talk properly with patients had been progressively stripped out of their system of care as a result of years of cuts in GP-led primary care.

Because GP services are not associated with any particular health condition, it is more acceptable and accessible for people with mental health issues and their families.

An ICGP submission to the committee states that over-medicalisation has become more apparent in the health system in recent years. There is a continued and almost exclusive focus on technical, hospital-based medical care. Over €1bn is spent on drugs every year, but less than €10m was spent on counselling in primary care.

Next year, the ICGP, with the National Office of Suicide Prevention, will roll out an education programme for GPS on suicide prevention and deliberate self-harm.

“We urgently need more GPs and practice nurses, so there is time for more, and earlier, talk therapy,” states the submission.

Committee chair, Senator Joan Freeman, said they wanted to learn how to deal with gaps in primary care.

Ms Freeman said it is crucial that vulnerable patients get the services they need at the first point of call.

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