Usually, the first steps to getting help if you feel you are having problems with your mental health is visiting your general practitioners’ (GP) surgery. A GP is a doctor who can provide treatment and care for your physical and mental health. This section provides information on what to expect from the appointment and what your GP can do for you.
•GPs can provide treatment for mental health problems and offer ongoing care and support.
•Sometimes it is worth asking whether there is a particular GP at your surgery who has an interest or speciality in mental health problems.
•Before an appointment, it can be helpful to write down a list of things you’d like to ask or discuss with the GP. This could be writing down a list of symptoms or perhaps side effects from medication.
•A GP will ask you questions about your mental and physical health and may make a diagnosis.
•You can change GPs providing it is within your catchment area.

This section covers:
•Preparing for a GP appointment
•What happens at an appointment
•What to expect next

Preparing for a GP appointment

The first steps to seeing a GP is to register with your local surgery or practice, if you are not already registered with one. You can find your local surgeries on the following NHS Choices page or by calling NHS 111 on 111.

You will need to be in a surgery’s catchment area, with the local area usually determined by postcode or address. You can register via a form that you can pick up at the surgery’s reception area or you can sometimes do this on their website. Once you are registered, you can then make an appointment to see someone. Usually, there are different GPs who all work in the same surgery, alongside other professionals such as nurses and therapists. You can make an appointment to see the first GP available, or if you are a returning patient then you can arrange to make an appointment with someone you’ve already seen, or a particular GP you prefer.

You can ask the receptionist if there is a GP with a specialist interest in mental health and request to see them. You can request to see a male or female GP. You do not need to tell the receptionist what you are making an appointment about. If they ask, you can explain that you’d prefer not to say, if you’d rather.

Sometimes you can see a GP through visiting local health centres that provide a walk in service. Information on where to find these services can be found in the useful contacts section.

Before the appointment, it can be helpful to write down a list of things you’d like to ask or discuss with the GP. This can be especially useful if you are feeling particularly anxious or worried, and could help you remember to ask something which you feel is important. You could consider writing down a list of your symptoms, and noting whether they might get worse at certain times or when doing certain things.

You might want to think about how you’re feeling and how your mood might be affecting your day to day life. A useful way of noting this sort of information can be a mood diary. We have included a sample mood diary here, which you may want to use or adapt for your own purposes. It could also be useful to make a note of any medication you might currently be taking.

You are entitled to take someone along to the appointment if you feel this would be helpful, such as a close friend, relative or advocate. If you wanted, you could bring someone along with you to the surgery for support while you are waiting but go into your appointment on your own.

At some surgeries you can arrange a telephone appointment where a GP will contact you over the phone to discuss your problems or any follow up care. If this is more convenient for you then you could check with the
surgery, although some GPs might still ask for you to visit them directly to discuss matters face to face.

The waiting time for an appointment to see a GP can vary. This depends on how busy the surgery is. If you need to be seen urgently, then you may be able to arrange an emergency appointment through the surgery’s reception. If you prefer to see someone particular then you might have to wait until an appointment slot becomes available.

Please see our checklist here, which you might find useful for filling in to take along with you to an appointment.

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What happens at an appointment

During the appointment, it is important to be as honest as possible and to give the GP as much detail as you can about how you’re feeling or how the symptoms are affecting you. They will ask you questions about your mental and physical health and may make a diagnosis.

A GP usually has an average of around ten minutes to spend with a patient. For some, this time can be too short and you might feel that you can’t get everything across during this time period. You can arrange a ‘double appointment’ if you feel you have a complex problem or need to discuss a number of things.

There will be a range of options that the GP will consider in getting you help. This might include prescribing medication, making a referral to a talking therapy service, referring you to a specialist mental health team or providing advice on maintaining your overall wellbeing.

NICE (National Institute for Health and Care Excellence) produce guidelines for NHS services on how they should manage certain conditions. Guidance can be downloaded from their website. These can be useful in letting you know what is recommended and how a GP should manage your treatment and care.

It is always worth asking why a certain treatment is being offered and whether there are other things that could help you to get better. If you are given any medication, your GP should tell you how it is expected to help and about any side effects that may occur. You may wish to ask about further information or whether there are any local support groups to help with how you are feeling.

You can also take this opportunity to ask for advice on:
•Smoking
•Alcohol or drugs
•Exercise
•Diet
•Flu jabs

A note of what was discussed at the appointment will be made. This will be recorded on your medical notes but will be kept confidential. Further information can be found in our Confidentiality section.

It is worth noting that although treatment and care through your GP is free, you may need to pay for prescriptions if you require medication.

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What to expect next

You can arrange a follow up appointment with your GP to see how things have progressed or to review any treatment options. You can ask to arrange the next appointment whilst with the GP if you’d prefer. If you have been prescribed medication then this should be closely monitored with regular check ups to see how it is working and how you are feeling. If there are any problems with treatment, or if your symptoms start to get worse, then you should make an appointment so that you can discuss these matters. Your GP may need to refer you onto a specialist under secondary mental health services to seek further or more experienced help. This is usually if a GP has tried all options and symptoms of your condition persist, if your problems seem too complex for the GP to deal with or if you are at risk of suicide or self harm.

If you have been referred onto mental health services, your general care needs including physical health should still be overseen by your GP. Your GP should liaise and work closely alongside mental health services and may accept recommendations from them. If you were previously under the Care Programme Approach (CPA) and have been discharged, then your GP will continue to provide your care and will be responsible for overseeing your health needs.

If you have a severe mental illness, such as schizophrenia or bipolar disorder, your GP should carry out a physical health check for you annually. Research shows that people with severe mental illness are at higher risk of certain physical health conditions. GP surgeries usually hold a register of all patients at the practice who have severe mental illness (schizophrenia, bipolar disorder and other psychotic conditions), which reminds the GP or nurse to contact you when a check is due. A health check may include taking your blood pressure, taking your pulse, doing a urine or blood test or weighing you. Further information can be found in our wellbeing and physical health section.

PROBLEMS WITH YOUR GP

Most people find that their GPs are supportive and proactive in their approach to helping and supporting with mental health problems. However, in the experience of our Advice and Information Service, some find that their GP do not take on board such problems and can be unsympathetic towards their needs. If this is the case, you could consider seeing a different GP. You can check whether there is a GP at the surgery with a particular interest or speciality in mental health then arrange any follow up appointments with this person afterwards. You can do this by checking with the receptionist.

If there is not another GP at your surgery that you felt comfortable seeing or if you would like to change surgery, you could also check whether there is another one in your local area. You can do this providing it is within your catchment area.

An advocate might be useful in helping you explore these options. An advocate is someone independent from health services who can help to make your voice heard with problems you may come across. There may be a local advocacy service in your area which you can contact for support. You can search online for a local service.

GP surgeries have to be flexible to help people with mental illness. Sometimes you might want to ask for changes in the way they support you.

For example you could ask to:
•Be able to book appointments later in the day. If your surgery only offers same-day appointments, you might usually have to phone first thing in the morning. If you are on certain medications you may not be able to get up at this time. You could ask to be able to book the appointment later.
•Receive appointment reminders if you think you might forget your appointment due to your condition. The surgery could send you a text or give you an appointment card.
•Wait in a different waiting area, maybe where it’s quieter. If you find it difficult to wait for your appointment with other patients, it is reasonable to ask for this.
•Have a longer appointment. You are entitled to ask for this.

If you need to, you could mention that surgeries have to make these changes because of the Equality Act 2010. They are called ‘reasonable adjustments’. More information can be found in our ‘Whats reasonable? GP Toolkit’.
If you feel unhappy with how your care is being handled, then the Patient Advice and Liaison Service (PALS) could be contacted, who can try to resolve any problems or questions you have. Their details should be available to you at the surgery, but you can also find your local office details through this website. If you wish to put in a complaint about a particular GP or surgery then your PALS will also be able to advise you on this. Further information can be found in our Complaining about the NHS or social services section.

The National Service Framework for mental health sets out basic standards for meeting the mental health needs of adults up to the age of 65. Standards two and three of the framework outline the standards by which mental health needs should be treated under primary care services (this includes your GP). These state that someone should have their needs identified and assessed and be offered effective treatments or appropriate referrals to meet these needs. If you feel that a GP has not offered effective treatment or considered your case properly then you might wish to consider these standards in formulating a complaint.

WHAT A CARER FRIEND OR RELATIVE CAN EXPECT

If you are a carer, friend or relative of someone and are worried about their mental health, you may wish to share information with their health professional, such as their GP. Unless the person consents, confidential information about them cannot be discussed, except in very limited circumstances.

There is no rule that says a GP cannot listen to your concerns, as this can be helpful for providing appropriate care. However a GP would not be able to tell you whether they took any action, and they might also talk to the patient about the conversation that took place. This is stated in the General Medical Council guidance on confidentiality for doctors. Further information can be found in our Confidentiality and information sharing – for carers, friends and family section. You could discuss with the person who is cared for about completing a consent form about information they permit to being shared. This could then be given to professionals involved with their care.

If you have concerns about someone you know but who are refusing to seek help, then you may wish to read our Are you worried about someone’s mental health section.