EXCLUSIVE: GPs say practices are being overwhelmed by a ‘tidal wave’ of patients needing mental health support, and admit they’re on the verge of burnout
GPs say they are being overwhelmed by a “tidal wave of mental health” appointments.
Family doctors say older women are now presenting with mental health problems linked to domestic abuse which they suffered in silence with for decades. The Mirror spoke to two GPs about the “harrowing stories” they encounter every day as they opened up about the burnout they face as a result of “relentless” workloads.
The number of patients registered with a GP in England has surged by 13% – or 6.6 million – since 2015. Despite an increase in GPs in the last few years, total full-time-equivalent (FTE) family doctors is still slightly down on numbers in 2015.
As well as an increase in patients, GPs face increasingly complex health problems from an aging population – much of these linked to poor mental health. Dr Eleanor Barnard, who works as a salaried GP in Sutton, south west London, told the Mirror she has been “on the brink of burnout twice and I brought myself back – but there’s only so many times”.
She explained: “People have horrific trauma. These women are having to survive and live with it for the rest of their life. Men too. And that knock-on impact that it has on their mental health, on their physical health, and on their capacity to work… we’ve only got 10-minute appointments.”
She added: “It feels like an absolute tidal wave of mental health [patients] that there are not enough mental health services to manage.”
Dr Jess Harvey, a partner at a GP practice with sites in Much Wenlock and Cressage in Shropshire, said: “I’ve ended up in a pretty dark place and had to have time off.
“You talk about the harrowing cases… it’s the relentlessness. It’s seeing somebody and telling them that actually they’ve got cancer… it’s having the conversation with somebody who’s just decided they can’t take any more chemo and then explaining end-of-life care and then having to have that conversation with their family.
“It’s then getting somebody in who’s really irate because their knee replacement surgery’s been delayed three times and then the parent who’s concerned about their child’s behaviour and doesn’t feel the school can manage it. The next person who wants an autism referral, and then the next person who actually is really acutely ill, and then somebody else who’s got a very minor problem but is just irritated because they’ve had to wait to see you.
“It’s it’s just so relentless. And then you add on to that a life event or two, and then before you know it you’re in a really difficult place where actually you can’t can’t manage things.”
It comes a week after an NHS survey showed one in four young people in England now have a mental health condition such as anxiety, depression, phobias and obsessive compulsive disorder.
The adult psychiatric morbidity study showed rates of such conditions in 16-to-24-year-olds have risen by more than a third in a decade, from 18.9% in 2014 to 25.8% in 2024. The conditions occurred in 36% of women and 16% of men.
Dr Barnard says GPs are effectively having to “upskill” to become psychiatrists and warns suicidal people have to be managed through mental health crises while on NHS waiting lists for as long as six months waiting for specialist counselling.
Ellie said: “We’ve got the highest rates of young people self-harm in the country. The risk threshold [of specialist NHS mental health services] is phenomenally high. So where do people go? They know we’re open, we can’t turn people away.
“We’re seeing it every single day here of us managing people through their crises until they’re seen – and that can be months while they’re waiting for therapy – and you’re carrying a lot of risk with that.”
Dr Barnard, works half her week as a GP and the other half at an addiction clinic. She said: “You come out of say, seeing 17 patients back-to-back with harrowing trauma… and you are physically and emotionally exhausted because you’ve absorbed that.
“You wouldn’t be able to function if you didn’t become a little bit hardened to it. That is why people burn out and it’s also why people work part-time.
“I cannot work as a GP five days a week with that level of intensity. You would burn out, you would probably physically have a heart attack very young.”
Latest data shows in May there were 28,956 FTE fully qualified GPs employed by NHS general practices in England. This is down 408 GPs since September 2015 when the GP workforce dataset started.
During this time, there has been a loss of over 6,500 FTE GP partners – who tend to be the more senior and experienced doctors. Many go part-time because of the risk of burnout seeing patients five days a week.
Jess said: “We have medical students come through and I ask ‘do you know what you want to do’? And a lot of them turn around, say they don’t want to do general practice because it’s too hard.
“I’ve done quite a few interviews and a lot of them have concerns around the workload, the demands, asking how many patients they’re going to see, what the admin burden is going to be.
“You wouldn’t want a surgeon rushing through your surgery. You wouldn’t want a surgeon being told ‘Well, you could take three gallbladders out in a morning before, but now actually we want you to try and do six’. Yet here in general practice, we seem to be saying that we can just be squeezed and work harder, faster… It just doesn’t work.”
Dr Carter Singh, a spokesperson for the Rebuild General Practice campaign group, said: “Never before have so few GPs looked after so many people with so many complex issues, including an explosion in mental health problems.
“General practice is the front door to the NHS. It makes 90% of patient contacts while receiving less than 10% of the NHS budget. If that front door buckles under the pressure, the whole health service will collapse.”
A spokesman for the Department of Health and Social Care said: “GPs play an invaluable role as the front-door of the NHS and supporting patients with a range of complex conditions, including mental health.
“To support hardworking GPs across the country and in recognition of the role they play in communities, we have recruited more GPs, invested £1.7 billion over two years, and placed them at the heart of our 10 Year Health Plan. Thanks to the changes we’ve made together with GPs, more than three quarters of patients are now reporting a ‘good’ experience, with major improvements in patient access to general practice due to the rollout of online services and the use of the NHS App.”