Talking to your GP

Many of us never ask for help with our mental health problems – or we wait until things are really bad before we do. It can be hard to know what do first.

Your GP is obviously interested in your physical health – but will also want to know about any mental health problems that trouble you.

It can be hard to take that first step, so we have put together this guide on what you can expect from your GP – and how to get the most out of your appointment.

We hope that this short leaflet can help you to feel more confident about talking to your GP about a mental health problem.

Disclaimer

This webpage provides information, not advice. You should read our full disclaimer before reading further.

This information reflects the best available evidence at the time of writing. We aim to review our mental health information every three years, and update critical changes more regularly.

©  November 2014 Royal College of Psychiatrists 

You might:

  • lose your appetite
  • feel low
  • worry more than usual
  • be more critical about yourself
  • be irritable or moody
  • find it harder than usual to concentrate
  • find it harder to enjoy life
  • find it harder to look after yourself - you may not feel up to washing or eating, for example
  • find it hard to sleep - or sleep too much
  • See or hear things that other people do not see or hear.

These things can happen slowly. It’s easy to ignore them – until you feel really bad. If you’ve noticed changes like this and feel that you just aren’t right, get in touch with your GP.  It can be hard to talk about your mental health, but most people find that their GP can give them help and support which makes a real difference.

“My GP has been absolutely amazing. He has been relentless in getting me help from every source possible. I would not be here today if it wasn't for him.” Jackie

They can:

  • Ask questions to help them – and you - understand what you are going through and what help you can get.
  • Refer you for a talking therapy.
  • Suggest medication.
  • Suggest practical things you can do to help yourself to feel better.
  • Make another appointment in a few weeks’ time to see how you’re doing. They may refer you to a specialist if they think that would be helpful.

If you feel that you just can’t go on or have thought of taking your own life, do talk to someone. You can:

  • Call your GP surgery and ask to speak to someone urgently.
  • Call the Samaritans on 116 123. They can give you someone to talk to over the phone, completely confidential, 24 hours a day.
  • You can go to your local A&E department and talk to a psychiatric nurse – but there may be a bit of a wait.

You must be registered with a local practice to make an appointment. It’s easy and quick to register with a practice near where you live.

You can change your GP if you want. This might be because:

  • You may need a practice that has specialist counselling or mental health services. You can phone the practice to ask what they offer, or look at the NHS Choices website.
  • You aren’t getting on with your practice or your GP.  England’s NHS Choices website lists patient reviews and gives each practice a Patient Survey score.
  • Ask the receptionist if there is a GP with a specialist interest in mental health - and ask to see them. You can also ask to see a male or female GP. You do not need to tell the receptionist why you are making an appointment. You can just say you’d prefer not to say.

This depends on how busy the surgery is. If you need to be seen urgently, then you may be able to get an emergency appointment through the surgery’s reception. If you prefer to see a particular doctor then you might have to wait longer, until they have appointment free.

It might be helpful to write down what you’d like to talk about, so that you don’t forget anything. Take a few minutes before the appointment to write a list of things you want to discuss. These could include:

  • How you’re feeling and how your mood is affecting your day to day life.
  • What’s happened in your life - upsetting events in your past and any current stresses.
  • Any medical information -  other physical or mental health conditions and the names and amounts of medications, herbal remedies or supplements you take.
  • Feel free to take a family member or friend along to your appointment if it will help you feel more relaxed.
  • Questions to ask, like:
    • What type of mental health problem do I have?
    • Why can't I get over this on my own?
    • How do you treat my type of mental illness or distress?
    • Will counselling or psychotherapy help?
    • Are there medications that might help?
    • How long will treatment take?
    • What can I do to help myself?
    • Do you have any leaflets or other printed material that I can have?
    • What websites do you recommend?

Don’t feel shy about asking your GP if you don't understand something.

Remember that you are not alone:

  • 1 in 3 GP appointments are for mental health and wellbeing issues.
  • 1 in 4 people will have some kind of mental health problem in the course of their life. Tackling problems early can stop them from getting worse.

A typical GP appointment is around ten minutes long. This may not be long enough to talk about a mental health problem. So - you can book a ‘double appointment’ if you feel you need more time to talk things over.

When you see your GP, try to be as open and honest as you can. They will ask a lot of questions to understand how you’re doing, so be sure to tell them how you’re really feeling and how your symptoms are affecting you. If you’ve written down some notes, you can use these to remind yourself.

It can be difficult to talk to someone you don’t know about your feelings. But GPs are trained to deal with sensitive issues in a professional and supportive way, so there is no need to be embarrassed. Everything you tell them is legally confidential, unless they are worried that you may be a danger to yourself or others.

When you see your GP, ask as many questions as you want and check the notes you have prepared. It is always worth asking:

  • Why your GP is suggesting a particular treatment.

  • Whether there are other things that could help.

If you know of things that have helped in the past, tell your GP.

Sometimes, just talking things over with your GP may be enough. But there are times when your GP may make a diagnosis and can suggest treatment. This could be self-help, a talking therapy, or medication. It can be about staying, as well as getting over your current situation.

If you decide to take medication, your GP should tell you:

  • How it might help.

  • What side effects might happen?

It can be difficult to take in everything your GP tells you, especially if you are feeling depressed or upset. If you don’t understand something, just ask your GP to repeat it.

Do ask for more information and support with how you are feeling. Write down anything you don’t understand. If your GP suggests medication, do ask what other things might be available - talking therapies, exercise or practicing mindfulness.

Your GP will make notes of what was discussed at the appointment and these are recorded on your medical file. This will be kept confidential, but you may also like to make a note of what was said after the appointment. You may know what steps you’d like to take after meeting your GP or you may need some time to think it over. You can let your GP know what you plan to do at a later date.

It’s usually best to have a follow up appointment with your GP. You can tell them how things have developed or review your treatment.

  •  If the GP has prescribed medication, he or she should see you within 2 weeks to see if it’s helping. If there are any problems with treatment, or if you feel worse, see your GP again to discuss it. They might need to refer you to a specialist for more help.
  • Even if your GP has referred you to a specialist mental health service, He or she will still be looking after your physical health. They should also keep in touch with mental health services.
  • If you have been under the Care Programme Approach (CPA) but have been discharged, your GP will look after both your physical and mental health needs.
  • If you have a longer-lasting mental illness, such as schizophrenia or bipolar disorder, you will be more likely to get some physical illnesses. So, your GP should arrange a health check for you every year. This could include:
    • Taking your pulse and blood pressure
    • Urine and blood tests
    • Checking your weight.

You can ask for a second opinion from another GP or a specialist:

  •  If you’re unhappy with how you’ve been treated.
  • If you want to confirm that the advice or support you were given was correct.

You can also make an appointment with another GP in the practice, or change practice altogether if your GP refuses to arrange a second opinion for you.

Sometimes seeing a different doctor can make all the difference.

“When I first became ill and went to the GP with whom I was registered, he was useless and unsympathetic. I was advised by a friend to see a different GP in my practice. WOW what a difference; right from the start he listened, empathised, gave me the time and support I needed when I was scared and confused and referred me to the correct mental health service.”

If you're unhappy about the service you’ve had from your GP, or the practice, you may want to make a complaint. You can talk to the GP or Practice Manager, or put it in writing.

A leaflet in the practice reception or on their website will tell you how to make a formal complaint.

If you don’t feel happy with the way they have dealt with your complaint, depending on where you live in the UK, the NHS complaints process may be slightly different. 

If you don't want to complain directly to your GP surgery, you need to contact:

Under the NHS Constitution, you have the right to have your formal written complaint acknowledged within three working days - and then to have it properly investigated.

You can also take your complaint to the Parliamentary and Health Service Ombudsman if you aren't satisfied with the way your complaint has been dealt with by the NHS.

This factsheet was produced by the Royal College of Psychiatrists' Public Engagement Editorial Board.
 
We  are grateful to the Mental Health Foundation for giving the College permission to adapt their leaflet on 'How to talk to your GP'.
 
Series Editor: Dr Philip Timms