The mental health consultation in General Practice—GPs could do more in the time they have

Dear Editor,

I read with great interest the article by Morgan et al.¹ about what patients with low mood find helpful in General Practice (GP) consultations. Drawing on their findings as well as my own experience whilst on placement at a GP practice in London, I would like to make my own suggestions about how mental health consultations in primary care could be improved.

During my placement last year, whenever I was present in a mental health consultation, even though they were meant to keep their appointments to 10 minutes, the GPs would deliberately allocate as much as 20 extra minutes to such an appointment; even with this extra time, they often recognized that this wasn’t enough to achieve the points made by Morgan et al.¹—showing patients that they were being listened to, using empathy, and helping the patient feel more hopeful for the future. Within the time constraints of a 10-minutes consultation, achieving these objectives is incredibly difficult.

A solution to this problem would be to increase not only the time allocated for consultations, but also the number of GPs recruited to help shoulder the burden of longer appointments.² If this is not feasible, GPs must find ways to do more with the time they have. A potential strategy would be to introduce screening questions that patients answer when they make an appointment online, or a “mental health clerking proforma” that patients can fill out on arriving to the practice. GPs could then quickly read through the text that patients have written beforehand, thus allowing the time during the consultation to be used to adequately explore the patient’s issues using the aforementioned techniques, rather than just eliciting them. Such solutions may become increasingly necessary as mental health problems become more prevalent in an increasingly complex patient population.

Funding

The study was funded by departmental resources.

Conflict of interest

There are no conflicts of interest to report. There are no new data associated with this article.

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