For many people who are suffering from mental health problems their first point of contact will be the GP. Because of this it is important that you get on well with your GP. If you don't get on well, try sorting the problem out by talking to your GP about this, but if you feel they are unsympathetic change your GP to one who seems more helpful. You don't have to give a reason why you want to change - just go to a new surgery and tell them you want to register. As soon as the new doctor signs your application form, s/he is responsible for your primary care, even though it may take a few weeks for your notes to arrive.

Everybody who wants a general practitioner has the right to one - but it is not necessarily the doctor the patient chooses. If you are having trouble registering contact the Community Health Council or an Advice Centre. Sheffield Health will allocate you to a doctor if you can’t find one to take you.

Why people go to their GP

Often because they believe that something is happening to them which they can't control. Often the GP will just try and calm you down and reassure you that you may be having a perfectly understandable reaction to something.

How long will my appointment with GP last?

An average appointment with the GP lasts for about 6-8 minutes - if you feel you need more time ask for a double appointment or for an appointment at the end of surgery. If you are very distressed the GP may arrange to see you about once a week until you have been referred on to other services.

How do GPs make a diagnosis?

Most GPs have a basic knowledge as to the causes of mental health problems and some rely on a fairly simple diagnosis - the medical model. They will attempt to find out what your symptoms are and prescribe treatment based on this - the "fitting people into boxes" method. The not uncommon treatment for this is medication.

Some GPs use a more complex method of assessment which involves trying to understand more about you. They will ask how you are feeling and if anything has happened recently to trigger these problems, for example, relationships, work and so forth. Medication might come into this as well but further support might also be recommended.

What about mis-diagnosis?

A lot of depression is missed by GP's who concentrate on physical problems. Try and tell your GP that you are depressed - if you feel you can't, take someone with you - most doctors should be OK about this. If English is not your first language ask for an interpreter - tell the doctor if you haven't understood what you've been told. It's their responsibility to understand you - not the other way around.

It is likely that a GP will not give you a diagnosis on the first occasion and you are not stuck with an initial diagnosis for ever. But it might make a difference in the short term so if you are not happy with a diagnosis then ask your GP to explain it and if you are still not happy ask for a second opinion.

What will a GP ask?

The questions the GP will ask depends on what they think the problem is. If they think it’s stress they will ask general questions about how your life is going, if they think depression is the problem they might ask about sleep and eating patterns and suicidal thoughts. Its been shown that most people who self harm talked to their doctors in the 3-4 weeks beforehand. If the GP suspects psychosis they might well ask questions about thought patterns.

What if I can't tell my GP?

If you don't want to talk to your doctor, tell them you'd like to speak to someone more specialised or who you don't know

Will they offer me medication?

Medication is not usually offered on the first occasion. If anti depressants are suggested it is usually for six months which can then be extended. The GP should explain what they are prescribing why and

what the side effects will be - if they don't, ask - these are major drugs and you need to be informed. If you have any problems with medication go back and tell your doctor.

What if the GP or I think I need more specialised help?

For many people the GP will be as far as they need to go. However if you feel you need to go further, but your GP does not consider this is necessary, then ask for a second opinion or look for help elsewhere. An individual has no right to demand such additional care. Services can also be limited depending on what is available to the GP's practice.

Backing up the GP is the Primary Care Team - this consists of those who work at the doctors surgery and a locally based Community Mental Health Team.

If you are referred on to a Community Mental Health Team this can be done immediately but most referrals take about 4-6 weeks. Psychiatrists do outreach to some surgeries and you can be referred directly to a psychiatrist this way.

Counsellors

People are often referred to counsellors because they ask to be and the GP believes the problem needs to be talked through. If you are referred to a counsellor, the counsellor will do their own assessment (normally within a couple of weeks) and if they think counselling will help will normally tell you how many sessions they think it will take. You will then go on a waiting list - on average expect to wait a couple of months.

What if a referral does not help?

If the doctor refers you on and the person you've been referred to is not helping try and discuss it with them. If you cannot sort it out, referral is not a way to get rid of you - you can always go back to your GP and explain the problem and ask to be referred to someone else.

Who has access to my records?

All patients have a right to see any medical notes taken about them since 1991 and if you’re not happy about what's in them ask them to be explained. However, under some circumstances, the right to see your notes can be refused if, for example, the GP felt that knowing what was in them could be harmful to you.

The notes remain in the surgery and information about a patient will remain confidential within the team - this means if they think it necessary a GP might seek advice from the counsellor, another doctor or a Community Psychiatric Nurse.

The practice counsellor will keep their own notes which may or may not be confidential to you and the counsellor. You need to ask about what is the Practice policy about counsellor's notes.

In this day and age all GP's are more aware of the costs of services. Some people feel that people with enduring and severe mental health problems are not given the attention they require because of cost. Some GPs have less interest and experience in mental health problems. If you feel this happening change your GP to someone you feel will be more sympathetic. It often helps to talk to other patients about their doctors before deciding which practice to apply to.