Cork GP reports increase in patients with mental health issues

A CORK GP said he is prescribing anti-depressants to many patients unable to access counselling during lockdown.

Dr Declan Mathews, of Emmet Place Family Practice in Youghal, said the number of people coming to him with mental health issues has risen due to extreme fear and worry around Covid. He added that while it was difficult to access counselling for patients pre-Covid, it has now become more challenging than ever.

According to Dr Mathews, the alternative options to treat depression are more scarce during lockdown.

“A big worry for GPs is that we will miss someone who wants to harm themselves. The fear is that if patients don’t get treatment they could act that out. The people coming to us aren’t seeking anti-depressants.

“They are presenting with mental health issues, depression being the most common, and Covid being the most glaringly obvious trigger. Many have suffered from depression and anxiety in the past. That isolation and fear has brought this on once again. Others have never experienced this and are coming to us for the first time.”

Dr Mathews also said that patients coming to him seeking help for mental health issues are getting younger; many are in their late teens and early twenties.

He said that when it comes to serious mental health issues, virtual counselling sessions are not enough.

“Normally if we see someone who is depressed we will wait a while before prescribing an anti-depressant. We will prescribe counselling or behavioural therapy.

“However, I have no doubt in my mind that, of all the conditions you can treat over the phone, a serious mental health issue is not one of them. You need to see the person and how they are behaving. You need to enquire if they have thoughts of suicide or self-harm. That’s much easier to do when they are in front of you.

“If someone comes to me I have to assess how depressed they are. The diagnosis forms half of the consultation. The other half is spent easing the patient’s fear around taking anti-depressants. A lot of people don’t like the idea of tablets because it reminds them that there is something wrong with them.

“They are afraid of getting hooked or that it will make them like a zombie. If I didn’t devote this kind of time to a consultation you can bet that these tablets won’t be taken and the patient will find themselves back to square one.”

He said that Covid restrictions have resulted in an increased need for anti-depressants during lockdown.

“Before, we would have been slower to give out anti-depressants. It would be unfair to say that counsellors have disappeared completely. It’s just become more difficult and zoom is not quite the same as seeing someone in a person. Much of the time, the GP ends up becoming the counsellor, a role that we are not trained for, or are always good at.”

According to Dr Mathews, a patient will remain on anti-depressants for six months.

“Usually, we’ll see a patient after 10 days to make sure there is no talk of self-harm and that they are taking the tablets. There can be bad days at the start, but within three to five weeks they are on their way to a better feeling and a better life”

Dr Mathews urged anyone struggling with depression or other mental health issues to speak to their GP.