Scotland’s GPs will be left to bear the brunt of a “rising tide” of mental health problems without a “radical overhaul” of services, a leading doctor has warned.

The head of the BMA’s Scottish GP Committee says “severe” criteria set by mental health services that must be met before a referral for more specialist help is accepted mean the majority of pandemic-related mental health cases will be rejected and left for GPs to try and treat.

Dr Andrew Buist told attendees of the Scottish Local Medical Committee Conference general practice was being left to deal with increasing cases of anxiety and depression “largely alone”:

“The widely recognised rising tide of mental health problems…is almost entirely falling – not on the specialist services – but on general practice to deal with,” he said.

“The increase in anxiety and depression will not pass the severe and enduring test our mental health services set, and we know all too well that such referrals will nearly always be rejected.

“So general practice is left to deal with this largely alone. It underlines once again why we need a radical overhaul of mental health provision in this country.

A practice in the Craigmillar area of Edinburgh is paving the way, says Dr Buist, when it comes to approaching mental health:

“Services need to be much more readily accessible to patients; we need to invest in bringing services closer to the patient along the lines of provision I recently saw at the Craigmillar medical centre, where the practice has a multidisciplinary team with three mental health workers ready to see distressed patients promptly and without a fuss of paperwork with inclusion and exclusion criteria…

“This is where the new contract re-design of general practice needs to take us.”

In recent months GPs have faced accusations they have had little to do during the pandemic.

The Blairgowrie GP vehemently called out such assertions for misrepresenting what GPs had been through in recent months when they had managed to transform services “overnight”, managing to remain open at a time when it was “not business as usual.”

Data from the rest of the UK covering recent months indicates contact between GPs and patients has risen by 20%. Although similar data is not available for Scotland, Dr Buist said there was no reason to believe things were different north of the border.

He explained such accusations risked undermining trust and left some GPs and their teams suffering verbal abuse from the public.

“We haven’t done enough in this country to let people know what is actually going on in healthcare,” he added, suggesting government needed to do more to manage patient expectations.

Earlier this year GPs working in some of the most deprived areas of Scotland made a plea for more community workers and money advisers to be stationed in GP practices as part of preparations for the economic and mental health shocks of covid-19.

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