Screen patients with LTCs for mental health problems, says RCGP lead

GPs should screen patients with long-term conditions for mental health problems, as part of a more holistic and effective approach to patient care, says the RCGP's mental health lead.

Dr Liz England
Dr Liz England

Caring for chronic conditions such as diabetes, COPD and chronic pain must include a greater focus on mental health, because up to 30% of patients also have depression and anxiety, said Dr Liz England, RCGP clinical lead for mental health and whole-person care.

Questions on the mental health of patients could be asked during routine appointments with their GP, or at chronic disease management clinics with a practice nurse.

‘One of the things I want to do differently is change the way we think about mental health,’ said Dr England, who will be speaking at the RCGP annual conference this week. ‘Rather than thinking purely about mental health, we’ve got to start thinking about how people exist as a whole.’

Screening high-risk patients, such as those with long-term conditions, is an effective way to pick up depression and anxiety earlier, in addition to improving patient outcomes.

Screening high-risk patients for mental health

Dr England said: ‘It doesn’t necessarily matter who sees that person, but somebody needs to be asking them about their mental health.

‘A lot of the checks could be done by the nurse, so you haven’t got to do everything yourself, it’s about working with colleagues effectively.’

If the practitioner has concerns, patients should be signed up for an appointment with their GP to look specifically at their mental health.

‘A lot of the time it’s just remembering to do it. You might ask simple questions, like "Is there anything else that’s worrying you? How are you feeling about things at the moment? Do you think you have any symptoms of low mood?"

‘It’s not necessarily asking them straight out – are you depressed? But it’s being aware that those issues might be there.’

Treating the mental illnesses of patients will improve their overall health, and GPs should be especially aware if conventional therapies do not appear to be alleviating symptoms, said Dr England.

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