Sarah

Brief Outline:

At university Sarah had depression. She was prescribed medication and went for counselling. She feels better now and is no longer on medication. She felt that the GP who’d helped most genuinely cared and didn’t see mental health as ‘a tick box that needs solving’.

Background:

Sarah is a PhD student and lives with her partner. Ethnic background / nationality: White British.

More about me...

As a child Sarah had little contact with local health services as she was usually healthy. The family doctor was later replaced by a new GP, who Sarah said ‘everyone raves about him and says he’s brilliant’. She prefers seeing him when she can rather than the GP she has where she lives. 

Sarah had to register with a new GP when she moved to go to university. The surgery there felt busy and impersonal, and the receptionists sometimes asked personal questions in front of other patients. Sarah felt that the reception area could be improved by separating it from the waiting room. Having a list of health problems at reception could also be helpful so patients could point at the reason for their visit rather than having to say it out loud. Sarah said she was aware that receptionists were overworked, and felt that any real improvements would need to address cuts in NHS funding. She had mixed feelings about email and telephone consultations because she felt that, with the privatisation of the NHS, these services could become mechanistic to save money.   

During her degree, Sarah had depression so saw the GP regularly. At her first consultation, the doctor prescribed her antidepressants but didn’t explain the different sorts of medications available for depression. She didn’t take them. She later saw another GP, when she was feeling much worse, and was prescribed a different medication. She also went to the university counselling service – although she disliked talking about personal issues with someone she didn’t know, she felt that counselling could be useful for some people. 

After university Sarah moved back in with her parents for the summer, and visited the GP in the village. This doctor had a reputation for taking as much time as needed for appointments and listening to patients. For Sarah, it made a big difference that he started the appointment by asking her how she was instead of what was wrong with her. She felt that he genuinely cared and didn’t see mental health as ‘a tick box that needs solving’. 

Sarah had been feeling better since and no longer takes antidepressants. She has also had appointments for contraception, acne and, on one occasion, campylobacter (severe food poisoning), for which she had to go to hospital. She was generally satisfied with the care she was given but stressed the importance of GPs being able to communicate well in English – she’d had an awkward appointment with one doctor whose English she’d found difficult to understand. However, Sarah said that she does not think that doctors have to be English and is in favour of doctors coming from overseas.  

Sarah advised friends who wanted to help someone with depression to listen actively and encourage them to talk. She also felt that it was important for people to accept that some health problems ‘won’t go away easily’ and do take time to resolve.

Sarah doesn’t like having cervical screening (smear) tests but the nurse was reassuring. Being friendly and relaxed are good qualities in GPs and nurses.

I had a really good nurse a couple of weeks ago, well months ago, for a smear test. She was brilliant. Because it was quite awkward. It’s not something I wanted to do but she was really good. She was really great and really reassuring and very matter of fact in a friendly way. 
I think that’s something I think nurses normally, normally are quite matter of fact about things, much more yeah I think... I think I’ve generally had a better experience with nurses but then maybe that’s because the experience that I’ve had that haven’t been so positive has been about more mental health issues, which I wouldn’t have spoken about to a nurse. So yeah.

So can you talk a little bit about the qualities of the nurse where you’ve often felt a bit more comfortable or you said matter of fact but friendly.

Yeah they are, they, the ones that I’m thinking of, mainly in [place name] actually I’ve seen nurses, have always been chatty and friendly and just quite open and more relaxed. It’s always felt a lot more relaxed, maybe because it’s been a less serious health situation, but there’s always been a much more relaxed and they’ve been, yeah they’ve just been really… yeah just kind of human really. Yeah.

Did you think the doctors could learn something from the nurses or vice versa at all in terms of like their mannerisms?

Yeah, I think if doctors’, doctors’ mannerisms were a bit more like nurses, I’m generalising here, there are some doctors and there are some nurses who would not fit that, but yeah I think being friendly and relaxed but also, yeah I think nurses laugh more, which I think is really important. 

But then at the same time I can completely see why it’s not appropriate for doctors to assume a jovial attitude. So, yeah, you get more of a sense of nurses as a community whereas doctors are kind of lone individuals and behind doors which is a little bit more intimidating, whereas nurses you see them chatting together and they’re, it seems much more integrated. Integrated beyond the computer, so they talk to each other rather than just send each other data.

The GP visited Sarah at home and an ambulance took her to hospital. She started feeling better after having antibiotics.

Campylobacter was a bit different actually to any health experience I’ve had in that luckily it was the only time I’ve been ever like seriously physically ill. And was written off work for five weeks with that, and was in hospital for a little bit but the doctors didn’t really take it seriously initially. I couldn’t really get to the doctors which was a problem. I managed to get to the doctors and didn’t really take it seriously. Asked me to come back with a stool sample, which always annoys me because I don’t know why you have to give stool samples in clear pots in clear bags, ‘cos it’s just awkward for everyone. I really think they should make something along those lines not clear for when you’re handing it to receptionists. But that’s just something that always annoys me. 

But once they’d found out what it was, they rang me at home and one of the doctors came round to my house and then so, and then called an ambulance and took me to hospital. But he was, as soon as there was a name for it, like okay it was Campylobacter, everything kind of swung into place and like the food standards agency and people were getting in touch and like all sorts of stuff. So yeah that was a bit different.

So that, at first, you know what kind of symptoms were you going to the GP with, where they –

Well I just had, I wasn’t vomiting. I just had diarrhoea, which is quite unusual for Campylobacter, and I had really bad stomach cramps, like crippling ones, so I couldn’t sit upright. And I wasn’t absorbing – this is really gross – I wasn’t absorbing water was my concern. And I knew I wasn’t, which is why I, it kind of got flagged as a problem, and I wasn’t taking in, so if I ate something it would come out as I’d eaten it. So there was no kind of situation of getting any nutrients out. So I knew I wasn’t well and I couldn’t really stand up. 

Sarah wanted to know about the different medications for depression but felt she wasn’t given all the options by the first GP she saw. She later saw another.

So I was going because I was probably, yeah I was, I think I had depression and I was trying to see a doctor and I didn’t particularly like the doctor that I saw. She was really nice but I, like just she put me on antidepressants which isn’t what I wanted to go on at all. And I’d said that I don’t necessarily want that and she was very much like, “Well the university has a counselling service, that’s separate from the doctors. We can’t really do anything about that apart from recommend that you go to it.” 

But it was very much like we’re here to treat this as a medical problem and give you a drug, which I didn’t really agree with. But then I kind of wanted to keep seeing her because I went back, ‘cos you have to go back, and saw another doctor who had said completely different things to what she’d said and then it got really confusing...
......It was very much like, “Okay,” she explained it was a really common problem, lots of people had it, and this particular drug would be helpful. And I didn’t want to go on that particular drug. And I more wanted a conversation around the possibilities of going on particular drugs in the future and it was very much like, “No, well if you’re here now, we should deal with that now.”

Did you feel you had much choice?

Yeah ‘cos you can always say no. But I didn’t feel like I was being, I knew there were more options out there than what was being explained to me.

So did she write you a prescription?

Yeah.

Yeah. And what did you do with that prescription? Did you –

No, I didn’t take it. I chose not to. But I went back and saw a different doctor who gave me a different prescription for a different drug, and I took that one. I think probably just because I was getting a bit desperate but it was a different situation.

Sarah found it awkward asking the GP for the pill the very first time. She advises preparing what you’re going to say beforehand so you feel more comfortable.

I think the first time I went I found it really, really awkward. I found it really awkward and it was really, really awkward but after that it’s been fine. And I think as I’m a bit older maybe, or just more used to things, the doctors, I don’t have a problem with talking to doctors about it. And it’s much more routine now...

So you mentioned the very first time you went that it was embarrassing. A lot of people might find that.

Yeah.

Can you talk a little bit about that and what might have been, what could have made that easier? Because a lot of people will be in that same kind of situation.

I think decide what you’ll say, you’re gonna say before you go in. Like I do that, sometimes I go into the doctors with like a mental list of like, I know you’re only meant to talk about one thing now, but like make sure you know what, how you’re going to phrase it, because if you go in and they’re like, “Okay how can I help you today?” or whatever, and you say something that’s a little bit weird, then it’s just a bit awkward. 
I think it’s a lot easier if you maybe have a sentence as like saying, “I’d like to get the contraceptive pill.” Or whatever.

So slightly prepare what you’re going to…

Yeah.

…talk about.

I think that’s a good idea. Yeah, definitely.  

Sarah advises booking an appointment in advance to avoid running out of the pill and messing up your cycles. If you do run out, it’s good to use other methods.

I’ve had to wait like, for the pill I’ve had problems when it’s been like, in [place name]. I think I immediately thought you could get a doctor’s appointment within two to three weeks and you can’t. You have to like book an appointment when you need to see a doctor every three months, you have to book the appointment when you’re coming out of that appointment.

Oh for the pill.

For the pill.

Because you’re going in routinely to get more?

Yeah, yeah. So the first time that happened, I think I thought, “Oh I can get one within two weeks.” And then was thinking, “I’m gonna run out.” And I did run out. But that’s not the end of the world, like that was alright. That wasn’t serious medication. And if it had been serious medication, something else would have been an option. But no I’ve never been to A&E.  I’ve only been to A&E for like, I broke my ankle once, but yeah.

So when you ran out of the pill?

Yeah.

If someone was in the similar situation…

Yeah.

…what would you advise them?

Use other methods of protection.

Till you get them?

Till you get the appointment. And keep it within rhythm with your cycles. So, if you ran out of the pill and have your period, and then wait until you’d normally start, like wait a cycle and then start again ‘cos it stops everything getting a bit mucked up. And take other forms of protection.

One surgery seemed reluctant to register students. Sarah wanted to be registered there, though, because she lived in the area all year round and preferred the doctors.

I had a bit of a problem with them, so there’s two doctors centres in [place name], one is the student one and one of them is the non-student one. And partly because I’m here all the year round I can’t really be at the student one because they shut down pretty much for the holidays, which is most of the year in [place name]. So I joined the other one. However the other one is quite hostile to students joining because they try and keep it separate, which you can understand. So you have to really fight to kind of say that, “I’m a PhD student, I’m here all the year round.” 

And they moved me between, like they are technically the same centre I think so they, I rang up to get an appointment once and they said, “Oh you’re not actually registered at this centre.” And I said, “Well I’m not, I am registered.” And they said, “Oh no we’ve moved you.” And it was like, “No. You can’t move me without my consent. I decided that and I am at this centre and I need to be here.” So that’s been a bit of a problem and, again, you don’t see the same doctor every time but they are, they really are better than at the other centre.

Sarah registered temporarily so she could see the doctor in the village. She registered permanently when she moved back home again for 2 years.

I went back home to the village that I live in, I could talk to the doctor there a bit more, or maybe I was just really upset and started talking about it, but yeah.

So year two and year three at university you were at the health centre, then when you finished Uni you went back home did you for a couple of weeks?

Yeah so by the, oh wait, yeah so I finished Uni, I was back home for about three months during which time I’d seen the doctor back home and during which time I stopped being on drugs. And then I moved to [another place].

So you saw different doctors at Uni, pretty much every time.

Yeah.

Was it there that they decided or you decided or together you decided that you didn’t want to take the drugs anymore. You felt that you didn’t really need to?

No, I think I decided that when I was at home. Yeah, I started coming off them when I was at home.

Yeah, so when you started coming off them did you talk with the GP about coming off them or?

Yeah. Yeah, I don’t think I, I was never on a dose high enough that you’d need to phase out but I knew that you couldn’t just stop taking them because that’s not good.

So you were at the Uni one and then did you have to re-register?

Yeah, so I’d been registered as a guest or as a visitor there when I’ve been at home in the holidays, but yeah I re-registered back at home.

Yeah, and how about the doctor in the village.

Yeah.

Were you seeing different doctors there as well?

No, same doctor every time.

Sarah advises booking an appointment in advance to avoid running out of the pill and messing up your cycles. If you do run out, it’s good to use other methods.

I’ve had to wait like, for the pill I’ve had problems when it’s been like, in [place name]. I think I immediately thought you could get a doctor’s appointment within two to three weeks and you can’t. You have to like book an appointment when you need to see a doctor every three months, you have to book the appointment when you’re coming out of that appointment.

Oh for the pill.

For the pill.

Because you’re going in routinely to get more?

Yeah, yeah. So the first time that happened, I think I thought, “Oh I can get one within two weeks.” And then was thinking, “I’m gonna run out.” And I did run out. But that’s not the end of the world, like that was alright. That wasn’t serious medication. And if it had been serious medication, something else would have been an option. But no I’ve never been to A&E. I’ve only been to A&E for like, I broke my ankle once, but yeah.

So when you ran out of the pill

Yeah.

If someone was in the similar situation

Yeah.

What would you advise them?

Use other methods of protection.

Till you get them

Till you get the appointment. And keep it within rhythm with your cycles. So, if you ran out of the pill and have your period, and then wait until you’d normally start, like wait a cycle and then start again ‘cos it stops everything getting a bit mucked up. And take other forms of protection.

Someone who wants to see the GP about mental health might not want to tell the receptionist or want other patients to hear their conversation.

I don’t know how this would work in practice. It would be good to have the receptionists as a way into the waiting room, so you talk to receptionist and go and sit in the waiting room, which is slightly separate so you’re not hearing people talking about what’s going on. You’re more with them. It’s more like a gatekeeper to the room to go in. 

And maybe, I guess the reasons, you can probably trace the reasons back why they’re overworked due to ridiculous cuts to the NHS. But I think if you had more time to train people to spend more time talking to people at the reception, which they’re never going to have I guess because everything’s getting tighter, that would be good. But I don’t think its nasty people, I think it’s just they’ve got to get through a list. 

Something you said that was interesting was they often asked you why you were going to see the doctor. 

Yeah. 

And you would have preferred maybe a list of things, it’s around this issue. 

So they have a list on the desk that says, “Are you coming to see the doctor about any of these issues? Contraceptive pill, rash”, whatever, and they are there on a list. And if you say yes, they send you to a nurse. Whereas if you say no they say, “What’s the issue about?” And if it’s a mental health issue, often you don’t want to say that. Well not just mental health, any issue you might not want to say. And you, I know you don’t have to say and I know that there’s a reason why they ask, but it’s a bit weird having that, sometimes it’s quite forced I think.

Appointments with Sarah’s GP lasted as long as she needed. He really explored what was wrong and then talked about the different options available.

He’s very good. He always asks you how you are at the start of every appointment in a way that’s not, it’s a “How are you?” Rather than, “What is wrong with you?” And I think there’s a very big difference in that question. It’s not, “You’ve come here for a purpose and I want to know what it is.” It’s, “How are you doing and how is your health?” And I think that for mental health situations is quite an important distinction. 

And the doctors at Uni, what was there kind of introduction when you came in? 

It would be, “So how can I help you today?” That kind of line they always say. 

With this doctor did you feel rushed at all or sometimes or not... 

No. So he’s got a bit of a reputation for taking like 45 minutes per patient so you can wait for a really long time with him. But it’s worth waiting. And I’d rather wait than not wait, like you might be waiting at the surgery for two hours but you know that, when you’re seen, you’re actually spoken to and he doesn’t just talk to you about one problem, it’s about everything. 

Yeah. So you didn’t mind having to you know to wait even if your… 

No. 

…appointment was 10 o’clock but by now it was half eleven, or something. 

No, that was fine. I always expect. It would be expected in the doctors, but yeah. 

But you don’t mind because you feel that he gives you all the time you need. 

Yeah. Yeah, it was worth waiting. 

You mentioned that with this doctor he often had an appointment like for 45 minutes if you needed it. 

Yeah. 

Can you remember any of the appointments you had with him that were much longer than some – 

It would have been long, yeah, it would have been long. One of, the first one was long, second one would probably have been normal-ish length. But yeah the first one was like, I was clearly not okay I think and he was like, “Okay, you’re not leaving here until we’ve got a solution that you’re happy with for now. And we’ll keep coming back until...” Yeah he was really good. 

So can you remember the time at all, or it’s hard to remember? 

It would have been about 45 minutes because that’s kind of how long his appointments always seem to last. 

So that’s, you know, that’s quite long for a doctor’s appointment isn’t it? 

Very long, yeah, it is long. But people keep coming to see him.... 

And so the first appointment was about 45 minutes and he really wanted to help find a solution and you were saying that you really felt like he did care? 

Yeah. I think it was more that he wouldn’t, because with another doctor, “I’m feeling like this.” They would say, “Okay it sounds like you’re experiencing symptoms that might be connected to X.” Whereas he’d be more like, “Okay, can you chat to me more about that. What do you mean when you’re feeling like that? What other reasons or what other, what’s triggering that other particular feelings within that?” Like he’d really push it. And then talk to you about the different options and things. 

The GP was ‘really good’. After Sarah got home from hospital, he phoned every few days to ask how she was getting on.

So were you given the antibiotics almost straightaway then?

Almost straightaway.

They took a sample?

They took a sample, it got processed like a high priority, and then within two days the doctor came over,

To your house?

To my house and then they took me in an ambulance to the hospital. And I was on a drip for, I wasn’t in overnight, they just put me on a drip for an afternoon, which was amazing. Everything a lot better and then I went back home, back to my house in [place name].

So when the doctor came to the house you got a phone call saying,

Saying, “Your tests have come back as campylobacter, can a doctor come round, like when is a good time?”

Did you have much information about that at the time or?

I googled it. They put, so they gave me antibiotics at the hospital. And I got the antibiotics prescription at the hospital. So I started taking them then.

So you stayed there about a day?

Yeah.

And then?

Came back. And the doctor would ring not every day but every couple of days to check in.

Right. That,

Yeah.

Did you feel - 

Supported? Yeah, they were really good. As soon as they were like, “This is what it is” they were really alarmed because, I think because and I worked out afterwards there had been an outbreak from this restaurant. If children get it or if elderly people get it, it’s really bad and if you’re pregnant and you get it it’s really, really bad. 

The GP didn’t explain why she wanted to prescribe one particular drug to Sarah, even when she asked. She felt that the doctor was ‘annoyed that I was challenging’.

Can you remember how the appointment actually went?

Yeah, I can. So she asked me what was wrong and I was really upset. And it was quite difficult to talk about and she was good. But when she’d, I think when she’d clocked right “She’s suffering from X, I need to give her Y” it became very one way and I was aware there was like, there are different drugs you can go on for this. There’s, you know, there’s more anxiety rated ones. There’s all sorts of different, there’s a spectrum. And I felt that wasn’t really explained to me. 

So I remember asking about it and she was getting quite annoyed that I was challenging. But I wasn’t meaning to challenge her. I was just saying like, “I don’t really know if I want this.” And I felt you were taking up her time and I think I probably was but, yeah, I’ve spoken to better doctors about that stuff.

........When I think back to it, I think that it was rushed, and it was quite quick, and maybe that’s in comparison to other conversations I’ve had with other doctors since, if that makes sense. Yeah.

So when you went and saw her. Did you feel that she listened to what you were saying?

Yeah, I think she listened but I think she then went down a particular route with it and was quite, “Okay, this is the route that we’re taking.” And there wasn’t much conversation around that route is how I would see it.

Yeah, and she talked about the route which was the medication route?

Yeah.

Did you feel that she explained why she wanted to take this route? Or...

No. It was very much like, “Okay.” She explained it was a really common problem, lots of people had it, and this particular drug would be helpful. And I didn’t want to go on that particular drug. And I more wanted a conversation around the possibilities of going on particular drugs in the future and it was very much like, “No, well if you’re here now, we should deal with that now.”

Did you feel you had much choice?

Yeah ‘cos you can always say no. But I didn’t feel like I was being, I knew there were more options out there than what was being explained to me.

So did she write you a prescription?

Yeah.

Yeah. And what did you do with that prescription? Did you...

No, I didn’t take it. I chose not to. But I went back and saw a different doctor who gave me a different prescription for a different drug, and I took that one. I think probably just because I was getting a bit desperate but it was a different, a different situation.

Sarah’s GP often spent 45 minutes with patients but it was worth waiting to see him. He was a good listener and genuinely cared.

He’s [GP] very good. He always asks you how you are at the start of every appointment in a way that’s not, it’s a “How are you?” Rather than, “What is wrong with you?” And I think there’s a very big difference in that question. It’s not, “You’ve come here for a purpose and I want to know what it is.” It’s, “How are you doing and how is your health?” And I think that for mental health situations is quite an important distinction.

And the doctors at Uni, what was there kind of introduction when you came in?

It would be, “So how can I help you today?” That kind of line they always say.

With this doctor did you feel rushed at all or sometimes or not....

No. So he’s got a bit of a reputation for taking like 45 minutes per patient so you can wait for a really long time with him. But it’s worth waiting. And I’d rather wait than not wait, like you might be waiting at the surgery for two hours, but you know that when you’re seen, you’re actually spoken to and he doesn’t just talk to you about one problem, it’s about everything.

Yeah. So you didn’t mind having to wait even if your…

No.

…appointment was 10 o’clock but by now it was half eleven, or something

No, that was fine. I always expect, it would be expected in the doctors, but yeah.

But you don’t mind because you feel that he gives you all the time you need.

Yeah. Yeah, it was worth waiting.

Yeah so you, you talk to him quite a bit.

Yeah.

And did you feel that he was a better doctor than the ones that you saw at university?

I think it depends how you define better. Better for me, yeah. It doesn’t mean he was a better doctor ‘cos it would be different for everyone, but for me, yeah.

Can you tell me a bit about his qualities? What made him better for you? The kind of qualities, so friendly or kind or understanding, good listener? What kind of qualities?

Yes, a good listener. He was definitely a good listener and asked questions that were not clearly questions that you’re meant to ask. So, and would remember things between appointments that you’d said that he probably hadn’t written on your notes. And like just other things, like my sister has been very ill and he has like, whenever she walks into the doctor’s surgery now, even if she doesn’t have an appointment, he will make time to see her between patients if he needs to. And that’s something he doesn’t have to do. And because he knows, I know he does things like that for people, I know that he cares. 

And he’s there till late at night because he’s overrun on all the appointments and he’s, you know, I think he’s a really good doctor. And he listens and takes you seriously, but isn’t patronising which I think is quite a difficult skill.

Sarah dislikes talking about personal things to people she doesn’t know. She found it hard to open up but felt that the counsellor was good.

And how did you feel about the counselling service?

I really hated it but I don’t think they were bad. Like I didn’t think it was, it wasn’t that it wasn’t helpful, I just really hated it. But I don’t think that’s a sign that they were a bad counselling service. So yeah...

Did you have one particular counsellor that you –

Yeah.

So were you able to see the counsellor quite regularly?

So I think you got five sessions and I think it was once, I want to say once a week. It was either once a week or once every two weeks, but I think it was once a week. Yeah.

And can you tell me what you liked and didn’t like about the counselling and then we’ll talk about maybe other things that might have helped or things that you might advise other people. So were there any good things about the counselling that you can remember?

Yeah. I think there were probably definite, there were definitely good things. I guess talking about things that you don’t want to talk about is probably a good thing in some ways. But yeah and they were, they were good and helpful and whatever, I just don’t think, I don’t know, I think I get quite, I don’t know, I don’t really enjoy it. But that doesn’t mean it’s not helpful and good. So yeah....

A few people also mentioned that. Some people found it helpful but other people felt it wasn’t for them at all.

Yeah.

Can you talk a little bit about why, why perhaps you didn’t like it or didn’t feel comfortable because maybe there’s something that,

Yeah.

…you know a service that maybe is better for younger people.

I don’t really know what the other options would be. Like I didn’t like it because I don’t particularly like talking to people that I don’t know about things that are quite personal. But that is the whole point of counselling so I’m aware of that and that’s a bit of a stupid opinion. But I don’t know what the option, other options would be for young people because if you want to talk to someone and you want to know about, if you need to talk about things, then you have to talk about them. So yeah I do think, I don’t know what the options would be.

So with that particular counsellor, you had five sessions, did you feel you could open up or did you feel it was really difficult and maybe you couldn’t because,

Yeah I didn’t but that was me, not her. She was good.

As a teenager, Sarah ‘wouldn’t have gone near anything that said this is for young people’. She would have felt that it was aimed at children.

I think the problem is when you partition off young people is that you’re already making a partition that is problematic because if you stick something in front of people, you’re kind of diminishing them as a person. So if you’re calling them “Young people,” it implies because you need separate treatment to “Normal” people and you’re creating a binary that I think is really problematic and I think actually, no, there shouldn’t be anything specifically for young, specifically targeted as ‘Young’. But I don’t know how you address that because, when I was a teenager, I wouldn’t have gone near anything that said this is for young people. Because I would have been like, “Well, that’s for children.”

Sarah didn’t want health services to become privatised. She felt that automated information over the phone is unhelpful compared to face to face consultations.

I think face to face is the safest in the sense that I think that all other ways of contacting your GP are, there’s the worry that that’ll become privatised and become, made into a mechanical voice on the phone where you punch in numbers. 

And I think, yeah, there should be other ways of contacting your GP but I’d be so worried about allowing that to happen. And that would, people would see that as a way of reducing costs in the NHS, but I wouldn’t want that to happen.

Talking about mental health is hard. It would be good if GPs acknowledged this at the start of the appointment and then discussed the options and plan.

I think initially saying that you understand this [depression] is difficult to talk about, and stating straight up that I accept that this is a problem and I believe you. And I want you to talk to me about these, if possible, so that I can show you a range of options available. So it’s talking, saying what you’re going to do before you then do it. So saying that these are the, you know okay, this sounds like you might have this, what they do, I’d like you to talk to me more about how you’re whatever doing about it, and then we’re going to discuss what options and you can pick one. 

So then it gives them, gives people the ability to take control of what they want to do and reassure them that going forward, you know, this will be followed up. We’ll take this together going forward. And I think it’s really, really important that you see the same GP. I don’t think you should move around GPs.

And you mentioned being given the options, like the very first time that you went you weren’t really given…

No.

…any options. So....

I think giving options is really important because it’s your health but it’s also you’re more aware of how you work than anyone who you meet is gonna be able to judge in a short space of time.

I think the key would be, I think like I said earlier, to see people as more than a health problem. And to see them as more complex than a particular line of treatment can sort out most of the time. But I do also think that listening, being friendly, being approachable, but all these are skills that are really dependent upon the situation that you’re in.