Bold claim: mental health isn’t a universal illness, yet the demand for diagnosis and treatment keeps rising. This is the core tension many England-based GPs are wrestling with, and it’s the focal point of this discussion. While some fear that normal life stresses are being medicalized, others worry that real mental-health needs are going unmet. Here’s a clear, accessible rewrite that preserves the original meaning and key details, with added context to help newcomers understand the issues and stakes.
Hundreds of GPs across England express a shared concern: mental health problems may be diagnosed too readily. They point to a broader cultural tendency to treat everyday stress as if it were a medical condition. At the same time, they caution that accessing appropriate support for patients with genuine mental-health needs remains challenging.
This week, Health Secretary Wes Streeting ordered an independent review to examine why demand for mental health services, ADHD, and autism supports has risen, and where gaps in help exist.
BBC News surveyed over 5,000 GPs in England about their experiences guiding patients with mental-health concerns. Among the 752 who responded, 442 believed over-diagnosis is a real issue, with more doctors saying it happens a little rather than a lot. Eighty-one respondents felt under-diagnosis was a problem.
Over-diagnosis isn’t the only worry. Many doctors also highlighted a lack of accessible help for patients.
As part of the survey, GPs answered several questions and could leave anonymous comments. A recurring theme captured a clinician’s remark: life’s stresses are not automatically an illness. In another note, a doctor observed that society seems to forget that grief and heartbreak are painful but normal experiences, and people must learn to cope.
A further critique argued that labeling emotions as anxiety or depression can over-medicalize normal life challenges, potentially diverting resources from individuals with more severe needs.
A minority of GPs criticized certain patients, with some describing them as dishonest or excessively self-serving in attempts to access care.
National statistics show that about one in five adults in England report a common mental-health condition such as anxiety or depression, according to NHS England data. Among young people, rates are higher, with roughly one in four aged 16–24 affected.
The participating GPs identified 19–34-year-olds as the group most in need of mental-health support. One clinician suggested that post-Covid resilience among young adults has diminished, implying they may prioritize diagnoses over learning coping strategies. Others countered that under-diagnosis is the real problem, arguing for broader acceptance, support, and proactive assessment.
There’s skepticism about whether the current system can keep up with demand. With around 40,000 fully qualified GPs in England, it’s unclear whether the respondents accurately reflect all family doctors’ views.
When asked how time spent on mental health work has changed over years of service (for those with at least five years’ experience), nearly all respondents noted an increase. The reasons cited were:
- Poor access to high-quality mental-health care elsewhere for patients
- Non-clinical factors like housing, employment, and finances impacting mental well-being
- The perception among patients that they have a mental-health issue even when facing normal life challenges
Earlier this year, Health Secretary Streeting told BBC’s Laura Kuenssberg that mental health conditions were being over-diagnosed and that too many people were being written off. He later characterized those comments as divisive and conceded they did not fully capture the complexity of the problem. The issue is widely acknowledged as serious and multifaceted.
Current estimates suggest about 2.5 million people in England may have ADHD, including undiagnosed individuals. Some ADHD services have stopped accepting new patients due to capacity constraints, highlighting the strain on the system. Patients describe significant difficulty obtaining appropriate care and ongoing support.
The consensus among GPs is that the NHS is struggling to meet rising demand in mental health care. A majority—508 of the 752 respondents—said there is rarely or never enough good-quality adult mental-health help locally. Even more, 640 doctors reported concern about securing adequate help for younger patients.
One clinician described mental health support as a national tragedy, while another warned that services disengage as soon as a crisis subsides—evidencing gaps in sustained care.
Regarding treatment choices, many GPs admitted prescribing antidepressants to bridge gaps when timely access to talking therapies or other supports is lacking. One respondent admitted recognizing that such medication may offer short-term relief but not prevent recurrence.
Professor Victoria Tzortziou Brown, chair of the Royal College of GPs, emphasized the delicate balance doctors must strike. She urged caution against medicalizing the full range of normal feelings and behaviors and against pressuring clinicians to diagnose where clinical judgment doesn’t support it. Conversely, she cautioned against dismissing valid mental-health concerns as mere over-diagnosis, which could deter people from seeking needed help.
The independent review aims to listen to all evidence and produce genuinely useful recommendations to address demand and gaps in care.
Additional reporting by Phil Leake.
Would this rewrite change your view on how mental health is diagnosed and treated in primary care? What steps would you suggest to improve access to high-quality mental-health services while avoiding over-diagnosis? Share your thoughts in the comments.
