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I am one of 3,000 GPs in Ireland who manage approximately 25m consultations annually. Most of these consultations are complex, dealing with more than one problem. About one fifth directly relate to a mental health symptom.
As trained specialists in mental health, knowing patients over time, in touch with their psychosocial needs, GPs are experts at listening, counselling, diagnosing, risk assessing, and managing mental health.
Common conditions which GPs manage include anxiety, depression, and addiction. All mental health symptoms require a holistic approach. Accordingly treatment options include social, psychological, and medication components. GPs manage most mental health difficulties without referral to other primary care colleagues, medication, and without referral to secondary care. But sometimes medication will be needed to manage a severe mental health symptom and this will include anti-depressants.
Accordingly the ICGP takes grave issue with the unbalanced interview with clinical psychologist, Dr Declan Ahern on October 10. Stating that GPs have “no training whatsoever in connecting with people” is anathema to health services research. Despite unequivocal evidence that anti-depressants work in both severe depression and anxiety, it is concerning that Dr Ahern stated: “There’s no viable evidence which suggests [patients] ought to be even on anti-depressants”. Inferring that medications have no usefulness, his remarks could precipitate some patients to cease taking a treatment, which could have disastrous consequences.
Anti-depressant prescribing has increased. One cause for this is under-resourced psychological services in Irish primary care. But a lack of resourcing of one area of the health system is no reason to attack general practice.
Dr Mark Murphy
Irish College of General Practitioners
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