This afternoon one of my junior colleagues mentioned that his wife had just finished her 3 years of GP training. During those 3 years she has not spent any time in psychiatry.
It takes 7 years of training to specialise in any particular medical discipline. But it is expected that GPs should know a little bit about everything in 3 years. That seems rather disproportionate. Without any training, how can they be well equipped to look after 1 in 4 of their patients who will present with a mental illness?
It is not uncommon to hear GPs say that when they call specialist services, they can sometimes be left holding the phone for hours. They often don’t get the support and advice they need. Some general practices have doctors with special interests, such as gynaecology, dermatology, psychiatry etc. Others don’t. Some GPs work in isolation. Others have no interest in psychiatry.
Of late the news has been resplendent with the issue of ‘hospital deaths’ being more over the weekends. It is almost illegal to die in a hospital as it brings a bad name to the organisation. However anyone can die unnoticed in the community and it seems to be nobody’s problem.
No health without mental health : a cross-government mental health outcomes strategy for people of all ages’ sets out six shared objectives to improve the mental health and well-being of the nation, and to improve outcomes for people with mental health problems through high quality services. The strategy was produced in collaboration with many of the Department’s partner organisations. It will enable more decisions about people’s mental health to be taken locally, and stresses the interconnections between mental health, housing, employment, and the criminal justice system.
For those who only understand the language of money, Knapp et al at London School of Economics studied the economic benefit of GP training and concluded that investment in GP suicide prevention training is cost saving overall from year 1. The intervention appears highly cost effective from a health system perspective alone.
Hence there is a strong case for suicide prevention training for GPs.