To disclose or not to disclose psychological problems to GPs

Abstract

Non-detection of common mental disorders in primary care is often interpreted as a reflection of GPs' knowledge and skills. A common approach to dealing with non-detection of mental disorders in primary care is to provide further psychiatric training to improve the rate and accuracy of recognition of mental health disorders. However, the findings from two recent studies on this topic indicate that this strategy is insufficient to ensure young people's psychological problems are not missed. In this issue, the study by Mauerhofer et al 1 on help-seeking patterns of young people shows that they are more likely to seek help for psychological problems from an informal source, such as an educational professional, than from a formal healthcare source. They also found that most of the young people who did not seek help for psychological problems had attended primary care at least once during the previous year. The study by Haller et al in the March issue of the BJGP highlights the multifaceted problem of identifying mental health disorders in young people.2 Their results indicated that non-detection of depression and anxiety symptoms in young primary care patients, aged 16–24 years, is associated with a young person's mental health literacy, health-related fears, frequency of consultations, and continuity of care. GP level of training in mental health or adolescent health care was not associated with identification of mental disorder. The results of both studies challenge the superficial appeal of GP psychiatric training as the sole strategy for improving recognition of mental health problems in primary care. Taken …