Going to the GP about self-harm

When parents and carers realise that a young person is harming themselves or having mental health problems they often seek support through their general practitioner (GP). The GP can refer them for further health service care if necessary. Some of the people we spoke to found their doctor very helpful, but others had mixed experiences.

GPs were praised by several parents and carers. Liz’s GP was ‘just lovely’; Pat and Jo both thought their GPs were ‘fantastic’. ‘I can’t stress enough that your first port of call has to be your GP and you have to get a GP that’ll listen to you,’ Audrey told us. ‘You have to get a GP that will sympathise, and want to be able to help you’. She described her husband’s current doctor as ‘phenomenal’.

Pat is very pleased with the service his daughter received from the GP.

Age at interview 43

Gender Male

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Jo’s GP was very welcoming and supportive, for both Jo and her daughter

Gender Female

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Audrey and her husband’s current GP is a superstar. He listened and didn’t make judgements.

Age at interview 30

Gender Female

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A few parents were reluctant to contact their GP. Sarah Z told us: ‘I suppose the missing bit is the GP, which we bypassed completely. That was really me being anxious about labelling her and getting her into a sort of system, where I felt that she didn’t need that kind of attention. She needed practical help and that’s what I wanted to get her straight away.’ On the advice of the school nurse Sarah arranged for her daughter to see a private psychologist. Jackie didn’t want details on her daughter’s records, and she had a low opinion of GPs.

Jackie had various reasons for not contacting a GP.

Age at interview 40

Gender Female

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Sometimes the young person themselves decided to consult the GP. Dot’s teenage daughter went independently to her doctor, who advised her to tell her mother about her self-harm. Dot said ‘the GP must have been brilliant’ as her daughter was then able to talk about her problems. Bernadette felt excluded because her son was old enough to see the GP as an adult and wouldn’t let Bernadette go in with him.

Parents were not always satisfied with GPs’ decisions about involving mental health services for their children. Charles had reservations about this: the doctor was ‘so concerned with his [Charles’s son’s] mental state that she, without reference to us, which is something we rather disagree with, referred him to the crisis centre of CAMHS [Child and Adolescent Mental Health Service].’ By contrast when Susan Y asked her doctor to refer her daughter to CAMHS he refused because he didn’t think she was mentally ill. Alexis was told by her GP that he couldn’t prescribe medication for her 16 year-old daughter, but the waiting list for psychiatric treatment was very long. He gave Alexis contact details for an expensive private psychiatrist. Jane Z had a ‘very good sort of old male GP, very bluff and practical’, who said it was too early to go down the CAMHS route and advised in-school counselling instead. Jane thought this was the right decision.

A few parents talked about unfortunate encounters with GPs. Although Jane S’s doctors were usually helpful she thought they were ‘completely stumped’ by her daughter. Susan Y felt her GP ‘had absolutely no idea about young people’.

Jane S’s daughter felt she had been dismissed’ by the GP and Jane felt shut out of the process.

Age at interview 54

Gender Female

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Susan Y’s GP told her daughter to grow up’ and refused to refer her to CAMHS.

Age at interview 47

Gender Female

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When Debbie first took her daughter to the doctor he said it was just a phase. Later her treatment was delayed because of confusion about his referral.

Age at interview 37

Gender Female

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It is important to find a sympathetic GP you have confidence in. This may be easier in GP practices where there are several different doctors. Audrey and her husband saw many GPs before they found one who was helpful. ‘We went through so many GPs that have just passed the buck with more tablets and more tablets and more tablets and it’s a vicious circle. It’s not helping the situation,’ Audrey told us. ‘If you’re not happy with whoever it is that you see and you want a second or a third or a fourth or a fifth opinion, if you have to go through every GP in that practice, you do it.’

The first GP Erica saw was unhelpful, but the second was amazing.

Age at interview 48

Gender Female

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Susan Z was disappointed with her doctor’s response to her daughter, but pleased that the doctor arranged for them to see a counsellor.

Age at interview 58

Gender Female

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Jane Z was pleased her daughter trusted her new GP enough to talk to her, but she still felt the system didn’t offer help when her daughter most needed it.

Age at interview 49

Gender Female

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Shame, stigma and taboo of self-harm

Unfortunately it is common for self-harm and mental illness to be seen as shameful and treated as taboo subjects. Fear of being stigmatised may prevent...