You may be surprised to discover that the supposition of popular philosopher and TheTimes’s columnist, A.C. Grayling, and your local GP probably coincide — roughly one third of all visits to the doctor’s surgery have a psychological cause.
It is widely accepted that there is a very real, but often indefinable, grey zone between diagnosable physical ailments, that GPs are trained to treat or refer, and recognised mental health issues which are referred on to the psychiatric service.
Two patients
A patient sits herself down somewhat self-consciously on the edge of a chair in her GP’s consulting room. It’s a bleak, rainy February morning. She tells the doctor she has constant headaches, feels faint and is not sleeping. Less than an hour later another patient dashes into the surgery, late for his appointment. Be-suited and nearly affluent, he is talking irritably into his mobile. He complains of palpitations, feeling sick and ‘run down’. ‘Yes’, he admits, ‘It’s frantic at work’. Our GP has around five minutes with each patient, knows instinctively, because she has seen these two patients before and checked that there are no presenting physical reasons for their symptoms, that she is dealing with problems in the grey zone. Because she can see no other solution she reluctantly prescribes anti-depressants, washed down, in the case of our mobile-berating friend, with a sick note for that demanding boss.
