How GPs are responding to mental health challenge – Prof Mike Holmes

In General Practice we’re being challenged – managing a different workload, in a different way; using technology more than ever, to connect with and treat our patients; proactively contacting our vulnerable patients.

As a healthcare team, we are worried about patients with non-Covid illnesses, those with long-term conditions and those who may be affected psychologically.

I see the stress colleagues are under, and want to encourage them to think about themselves and how they manage this stress. The Royal College of General Practitioners, NHS England, the Royal College of Nursing and many others have made resources available to help us think about all aspects of our lifestyle.

So, what is the message about coping with stress? We need to recognise it, acknowledge it and talk about it. A mechanism to talk about it has been launched by NHS England – #Lookingafteryoutoo – for everyone working in Primary Care and it has been widely welcomed.

From a wider perspective, dealing with lockdown and whatever comes next is a real challenge. We must be proactive with our diet and sleep pattern, whilst avoiding harmful choices such as too much alcohol. We also know social contact is important, even via a device or computer screen.

Exercise can really help too – however you do it. Of course, it means different things to different people. Allowing yourself to rest and embracing the opportunity to slow down can also be a positive.

One patient told me that she’d noticed her average resting heart rate had reduced by 10 beats per minute in recent weeks – just from exercising and sleeping better.

At Haxby Group, we’re exploring how exercise and increased activity can improve people’s health and wellbeing. We’ve certainly seen a surge in the amount of exercise our patients are doing since the lockdown.

So this week we’ve been asking them to complete a short online survey to gauge how much additional exercise they’re doing.

We want to measure the impact it is having on our patients and society in general. We want to learn more about what people are doing and what can help them become more active going forward. Exploring how it’s making people feel, both mentally and physically, will really help us all.

We’re hoping that we can use this to really measure the positive benefits to our health and wellbeing from this difficult period of time, and look at how we can continue with these routines.

Staying well and proactively managing our wellbeing is just one aspect of the challenge here. There are sadly people who already have a history of mental illness and those who are developing symptoms as a consequence of the lockdown.

What we have noticed is that the public have been really supportive and are trying to manage their health issues without contacting NHS services, including General Practice. At one point contacts were down by over 30 per cent.

One of the unintended consequences is that people are not presenting with signs of deterioration of mental health conditions or indeed coming to discuss new issues. For us this is a real concern.

Referrals for psychological therapies across North Yorkshire have dropped by over 60 per cent between January and April 2020. Early intervention at times like this is so important and our 
key message is that GP surgeries and our mental health services are available and open for business.

If you think a pre-existing condition is deteriorating, or you feel you are struggling with new mental health symptoms, then please do contact your GP surgery – you will be able to access a full assessment and the support you need.

In challenging times like 
this our concerns often turn to others – it is one of the key features of being human. However it is also okay to focus on ourselves.

Paying attention to our own wellbeing, whether at the front line of healthcare or at home with our families, is so important and can have real positives.

Equally if you’re worried that you’re suffering from, or developing, mental health issues, then seek help. Your GP is often a good place to start. By taking care of ourselves we can feel more confident we can get through this, whatever comes next.

Professor Mike Holmes is vice chair of the Royal College of GPs. He works for the Haxby Group in York and Hull.

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