Patients with mental health conditions in a pressured primary care context: access, experience and inequalities

PI Title: Dr Doriane Mignon

Lead member: University of Manchester

Mental health issues are a significant global challenge, with the rate of adults in the UK experiencing moderate to severe depression increasing from 10% before the pandemic to as high as 21% in early 2021. Many individuals seek help for mental
health issues from their general practitioner (GP), but primary care faces several challenges in managing mental health. One challenge is that many GPs feel underprepared; for instance, only about half of the GPs trained in 2017 had a psychiatry placement. Funding for mental health has also lagged behind funding for physical health, and while recent NHS plans have increased mental health funding, demand still outstrips available resources.

The experience of mental health patients in primary care has not been studied enough, especially regarding the impact of social factors such as geographical location, socioeconomic status, and ethnicity. General practice is under many strains in England at the minute, with fewer GPs per patient, high rates of burnout, and rising patient numbers and complexity—partly due to an ageing population. This might lead to a mismatch between demand and resources, and it is thought patients’
experience will suffer as a result. These issues are often worse in deprived areas, leading to greater health inequalities and possibly affecting patients with mental health issues even more.

The study aims to examine how patients with mental health conditions experience primary care and to identify any factors unique to this group compared to those with only physical health conditions. Specifically, the study will 1) document
differences in primary care experiences between mental health and physical health patients and 2) explore the factors influencing these experiences for mental health patients versus those without mental health conditions.

Using a large dataset with lots of information on patient experience, indicators of mental health and lots of other factors, we will compare the experiences of patients with mental health conditions against those with only physical health conditions.
We will see if patient experiences are different among people in different areas and those with differing access to GPs. We will explore healthcare inequalities along several dimensions: geographical, socioeconomic, ethnicity. By analysing patterns in
patient feedback and linking them with health policy tools, the findings could help shape future healthcare improvements and funding for mental health support. It will also give a platform to develop larger applications which will allow to better
tackle these inequalities.