Undeniably, on the whole, GP understanding of mental health and how it presents is frustratingly inadequate.
As the first point of call, it is worrying that GPs don’t receive more in-depth training in mental health as part of their education to enable them to have more understanding of how various mental disorders present and manifest.
The length of time that it can take from the point of patient referral to actually receiving an appointment with a mental health professional can be significant and therefore the earlier that the signs and symptoms of psychological distress are identified, the better the chance of helping the individual. What’s more concerning is that in certain NHS trusts, due to lack of financial resources and staffing issues, the standard procedures for carrying out mental health assessments are that they are carried out by someone with a non-psychological and non-psychiatry background.
Mental health presentations can be incredibly complex, especially in secondary mental health services and therefore someone who is not trained to assess someone psychologically may not be able to recognise the variations of how mental distress presents in different people. This may lead to people who seriously need help being missed.
I was recently made aware of a situation where a social worker in a crisis service didn’t understand how childhood sexual abuse could manifest and affect perceptions of abuse in an adult. This is something that should be core knowledge, especially for someone who is working in a mental health crisis team. It led me to question why a social worker was carrying out a psychological assessment on someone in mental health crisis in the first place.
In this particular instance, they actually caused the patient more harm than good. So how often is this really happening within the NHS services at the moment? Is this standard normality of using inappropriately trained people to carry out mental health assessments potentially contributing to the increasing suicide rates?
Perhaps this is why male suicide rates are so high, because they present differently to females when in crisis and their distress is not as easily recognised. If someone calls a crisis service and is presented with a member of staff who isn’t trained enough to recognise what crisis looks like unless it is the obvious one-dimensional view of crisis, how is that particular individual going to actually access the help they need?
Psychologists and psychiatrists undertake a minimum of seven years of education to become qualified, that doesn’t include all the work experience in between the stages of education and additional training post qualification. It takes a long time to understand mental health because of how complicated it is and people deserve to be assessed by appropriately qualified professionals when they are put through the mental health services.
Unfortunately, there still seems to be an underappreciation of how vulnerable the mind is and how vulnerable people are when they are accessing mental health services, and once someone is missed and let down by the system, the knock-on effect and further trauma that an individual can go on to suffer can lessen the chances of making a successful recovery from the problems that they are already struggling with.
We are all aware that there is a lack of resource in the NHS and we are trying to meet the demand of those that require our help. However, using professionals who don’t have the knowledge or qualifications to work in mental health will only cause more harm than good.
Consequently, this ends up further utilising costly NHS resources as services have to rectify and help patients who have been caused additional and unnecessary trauma. Getting the diagnosis, treatment and approach right in the first place would save the patient a lot of distress and would also save the NHS money.