Carers’ experiences of General Practitioners

General practitioners (GPs) provided information, referrals, medical care and advice to carers providing support for a person with severe mental health problems. This Talking Point is about carers’ views of the role of GPs in supporting the person being cared for, and the relationship between the GP, the person being cared for and their carer.

Most carers we interviewed said they appreciated GPs who developed a good understanding of the history of the person being cared for. Many carers believed this led to better mental and physical health outcomes for the person cared for. It also meant neither carers nor the person being cared for had to, in Sue’s words, ‘go over’ the same information repeatedly.

GPs were often the ‘first port of call’, as Bronwyn put it, when the person cared for first started to experience mental health problems. Consequently, many carers felt GPs were in the best position – when the person cared for first became ‘unwell’ – to provide information and support to the person cared for and his or her carer. Many carers felt GPs needed to be better equipped to refer people to the full range of services they would need to build what Bronwyn described as ‘a support system’, and to do so in a coordinated way. Some carers specified that such referrals needed to include ‘non-medical’ support organisations, such as support groups, respite care and home care. A few carers wanted to see more case managers who could provide this coordination, and felt that the GP would be the best professional to explain to the person cared for and carers what a case manager did, and to refer them for case management (see also Advice for other carers).

Quick Links

Prescribing and monitoring medication
Carers and person being cared for’s relationship with General Practitioners

Bev would have liked it if her and her son’s General Practitioner had been able ‘from day one’ to refer them to ‘one particular spot’, which linked everything carers needed to know to better support the person being cared for towards recovery.

Some carers commented that there were times when the person being cared for’s GP had not referred them to effective information or support. A few carers found that services they were referred to by GPs did not provide what they needed. This meant they had needed to approach a number of services before they found what they were looking for. It was also important to some carers that, as part of the ‘package’, as Bronwyn put it, of care their loved ones received, constructive communication existed between GPs and the mental health practitioners to whom GPs referred people. Many carers said they would also like to be referred by GPs to support services for carers because, as Julie put it, ‘[carers are] going to need help’.

Julie described how it was not a General Practitioner or a mental health practitioner but a ‘counsellor’ at a carer support organisation who gave her advice about alternative avenues she could pursue at a time when she had doubts about the ‘psychiatric care’ her daughter was receiving.

Prescribing and monitoring medication

Many carers said GPs played a crucial role in prescribing the person being cared for’s medication, and observing its effects. GPs initiated new medication and provided ongoing prescriptions for some medication initiated by specialist mental health practitioners. A few carers would have liked GPs to pay more attention – beyond just prescribing medication – to their loved ones’ general wellbeing such as their emotional health and lifestyle concerns. One carer, Christene, felt that GPs held increasing responsibility for people diagnosed with ‘mental illness’ that was once the remit of mental health practitioners.

Jeannie felt that her son’s General Practitioner focussed predominantly on prescribing him medication.

Christene, a regional carer, felt that ‘more and more’ responsibility – including responsibility for prescribing medication – was being ‘put back onto’ General Practitioners.

Carers and person being cared for’s relationship with General Practitioners

Many carers commented that GPs were unique among the medical professionals with whom the person cared for had contact, specifically with respect to providing continuity of care. Some families had stayed with the same GP for many years, which carers said allowed for relationships to develop that they felt were beneficial for both carers and the person being cared for. Bev described how she felt ‘very, very fortunate’ that her son had been seeing the same GP for the past 30 years since he first became ‘unwell’: ‘So, we have a very good relationship with him. [Son’s] GP understands the family dynamics and I can’t say how lucky we are to have that same GP. We don’t have to go over the same story all the time’.

Some carers were able to attend GP appointments with the person being cared for, and they said they appreciated the willingness of the person being cared for and his or her GP to include them in appointments. Several carers said attending the person cared for’s GP consultations was useful because it gave carers a chance – with the person cared for’s consent – to take notes, receive advice and discuss their observations with the GP.

Bev appreciated that her son allowed her to attend his appointments with his General Practitioner.

A few carers commented, however, that in their experience, when the person being cared for had found a GP with whom he or she had established a good rapport, it was not always possible to have the same GP as the person cared for’s regular doctor. In some instances, this was due to a GP relocating his or her practice or not always being available because he or she worked part-time.

Bronwyn believed that lack of continuing care by the General Practitioner who first diagnosed her son with mental health problems led to a lack of communication between the practitioners treating her son. She said this created the necessity for carers to be an ‘advocate’ for the person being cared for.

A few carers commented that GPs – particularly GPs who regularly cared for both the carer and the person being cared for – had been instrumental in encouraging carers to take time out to look after themselves (see also Carers’ experiences of caring for themselves).

Rowan’s stress levels peaked when he no longer had an income or savings which, as his GP alerted him to, put him in danger of having ‘a coronary’.