GPs report large numbers of patients suffering mental health issues linked to poverty
GPs in some surgeries estimate that up to half of their patients are seeking help for mental health issues caused or exacerbated by poverty, according to a new study.
Doctors and families have said changes to welfare policy and recent cuts in public spending are contributing to emotional distress, research into the lives of families in two communities suggests. People have told researchers they feel they have no other option but to turn to their doctor, leading to poverty becoming medicalised.
Experts have said changes to support for deprived communities are needed to stop the stresses of poverty continuing to become a medicalised issue for patients.
GPs who took part in the study told researchers they estimate at their surgery a range of 10 per cent to 50 per cent of their patients had sought treatment for psychological problems caused by poverty, and the process of claiming or being re-assessed for benefits. These proportions had increased in recent years.
Dr. Felicity Thomas, from the University of Exeter, who led the study, said: "Doctors told us they are increasingly seeing people with mental health problems requiring medical attention which are caused or exacerbated by the challenges of poverty and deprivation.
"This is a real problem for all involved—both patients and doctors because GPs have limited options to help patients in this situation—often only antidepressants or talking therapy. But if patients continue to face the same stresses in their life these won't be as effective as they are intended to be, and antidepressants can have unpleasant and potentially harmful side effects."
The findings are outlined in a new report, Poverty, Pathology and Pills, produced as part of the project, called DeStress. Researchers examined the impacts of austerity and welfare reform on mental health and wellbeing in low-income communities. The project was run by academics from the Universities of Exeter and Plymouth, and City, University of London, who worked with an advisory board comprised of residents, health professionals, civil society groups, policy sector representatives and academics.
The Economic and Social Research Council-funded research took place within parts of Plymouth and a coastal town in South Devon that experience high levels of deprivation. The project team ran 16 focus groups with 97 residents in the areas and carried out 80 in-depth interviews with 57 people who had experienced poverty-related distress. They also interviewed ten GPs working in the areas nearby and analysed 52 video-recorded GP-patient consultations recorded as part of a separate study by University of Bristol.
GPs who took part in the study told researchers they felt frustrated they had become caught up in current and previous Government drives to change welfare policies, and felt they needed to try to protect their patients from the impacts of this. They also reported concern about the 'fractured' nature of mental health provision and the difficulties they faced referring patients to appropriate mental health care.
A total of 81 per cent of patients interviewed—who had volunteered to take part in the research—had been prescribed antidepressants at some point in their lives. A further 7 per cent had been offered antidepressants but had refused them. Many had been taking this medication for a long period.
People interviewed said they felt there was now a more negative attitude towards people claiming benefits in their area, and they felt more isolated because cuts in public spending had led to the cut-back of community-based services such as libraries, Citizen's Advice Bureaus and charity-run groups. This put increased pressure on the services that remain, and in particular, on GP surgeries.
Experts working on the DeStress project have been collaborating with Health Education England, health practitioners and community partners to develop training materials for GPs on how to use the limited time available within consultations to more effectively engage with people experiencing poverty-related distress. The training materials that have been developed will be made available on the project website (http://destressproject.org.uk) and are currently under review for accreditation by the Royal College of GPs.