To think the GP receptionist should have asked, 'Are you ok'?

[shonapop]

My mood has been slowly spiralling downwards. I've had many gentle suggestions from family that perhaps it's time to think about increasing my anti depressants.
I've been really putting it off, trying to fix myself with all the usual exercise, meditation, etc. Just getting worse.
Plucked up the courage to call the GP today, feeling like a total failure and on my way to rock bottom.
Told the receptionist 'I think I need to tweak my antidepressants' she said 'I can't get you a phonecall with a GP until next week ' that was it. Didn't ask if I was ok, was it an mental health emergency? Or even what direction was I wanting to tweak them.
What if it was someone AT rock bottom? Suicidal? Can't believe the lack of compassion.

This is unacceptable behaviour from a receptionist. I am sorry you were treated this way. Just awful.

OP, your situation is not really the same. Try to move on from this.

“I'm going to be ok but what about the next person who calls that isn't?”

when you’re feeling off-kilter it’s common to feel an overwhelming sense of need to worry about others and to fix things on the wider spectrum. This can actually exacerbate your own mh. Your thinking if I’m not ok someone else may feel the same or worse is well placed but not your problem at this moment in time.

it’s ok to be selfish and only worry about yourself when you feel like this, you don’t need to worry about the next person along.

hope you’re feeling better op 💐

Our GP receptionists do ask questions, so I'm not sure you are being unreasonable.

They have it on the surgery website, and also say you don't have to answer the questions, but imply that it helps them prioritise appointments.

Ideally there would be more training on mental health for receptionists, and GP's, but that's another issue.

When I had (undiagnosed) depression and it culminated into a bit of a breakdown when I rang the GP the receptionist couldn’t have been more compassionate and helpful.
I literally just said ‘I need help’ and broke down in tears and she was so kind, asked me to stay on hold and said she would see what she could do for me, and I ended up having a GP call me back within a couple of hours.

I was so grateful as I probably wouldn’t have had the strength to stay on hold or wait several days for an appointment etc

I do get it, I have been where you are and understand that things like this can be really distressing almost (not sure how else to describe it); but as has been said the reality is that the receptionist is limited in what they can do- what would you expect them to do bearing in mind the confines of their role if you said actually no I'm not? The reality is they can't magic more appointments out of thin air nor are they trained to give medical advice. Sure they could have signposted to if you can't wait til then phone 111 or whatever, but then some would find them intrusive- it's a hard balance.

By all means give feedback to the practice manager and it might be that they can review the processes, but I wouldn't feel badly towards someone doing their job and not stepping out of the role. If they gave incorrect advice they'd be in serious trouble s probably would the surgery.

I'd look at it as she listened and booked you an appointment without probing etc so evidently felt that you do need to see someone and that your needs are important.

If you'd have said I really can't wait until then she might well have escalated and done more, but she isn't a mindreader.

This happened to my MIL when she was feeling suicidal. Her husband rang back complaining and saying it was an emergency and they apologised and the head GP rang her back that day.

She ended up seeing a psychologist not long after and got diagnosed with Bipolar, and has been on the wrong meds for 20 years with all sorts of negative side effects.

Na not their job to do that. They are not a personal samaritans hotline.

I think this is probably how they determine who needs to be a priority.

It sounds crap but if you just accept the appointment they assume you're ok. If you tell them you're desperate they'll get help, but it's hard to push sometimes when you're feeling vulnerable too. Catch 21.

In the nicest possible way, yabu

I absolutely understand what you are saying, however, as someone who works in MH, the receptionist asking you if you are ok could potentially open up a whole can of worms that they are not qualified to deal with and they would not know the correct way of dealing with the response you may give to that question. It would also not be appropriate for someone to be questioned to the point of disclosing just how bad they feel to then just be left with that for however long without any advice/referrals/appointments/safety plans etc. I agree that saying, I need to tweak my anti depressants, does not come across as urgent. It does not reflect how bad you are feeling. I also agree that you may of got a different response if you had of worded it differently, such as, i have been really struggeling and feel i am at rock bottom and feel i really need to speak to someone as soon as possible. It may be worth calling back and explaining how you are feeling, they may well be able to get you to someone quicker. In the meantime, whilst you are waiting, please have a look at breathing space and shout if you feel you need someone to talk to whilst you wait for your appointment.

I think if the receptionist asked everyone if they were ok, she’d never get any work done. She’d hear chapter and verse from many patients about their headache, back ache, itchy arse, problematic knee, dodgy shoulder. Her job is to book appointments, she did that. Personally if I was depressed I would not want to go in to much detail to bloody Sue on reception.

Asking questions about psychiatric meds is a bit different to asking about physical ailments. It's a far more private subject, so I can see why the GP was cautious in response to something as general and casual as "I think I need to tweak my antidepressants". Psychiatric meds almost always need tweaking/mild adjusting, I certainly wouldn't want to be given the 3rd degree over that by a receptionist.

If you had said it was urgent or a mental health emergency, I think the outcome would likely have been different.

I used to work as a GP receptionist, although not in the UK. If anyone signalled a need for an urgent appointment and there was nothing available we were trained to put them through to the practice nurse (or get the nurse to call them back), and if it was urgent she would find a way to squeeze them in with one of the doctors. The rationale for this was that receptionists have no clinical training so we should not try to assess whether a medical problem was urgent or not.

In the circumstances the OP describes I would probably have said something like "the earliest appointment I have is next week, will that be ok?" and if you expressed any doubt or concern I would have offered you a conversation with the nurse. Certainly if the patient mentioned a mental health issue I would always err on the side of caution.

It does bother me when I call to make an appointment at my own GP and the receptionist says "is it an emergency?" before deciding whether to offer me an appointment in the next 3 days, as opposed to in 3 weeks' time. No, if it were an emergency, I would go to A&E.

With kindness so many people are on anti-depressants, many of whom are not in any kind of dangerous place, ringing up to say you need to tweak them just wouldn't sound urgent.

When they say highly trained they mean that if you don't volunteer what you need, she'll ask the right questions to get you sent to the right person, not that she's going to help you herself. She has no medical training, and her job is to get people booked in. She simply doesn't have the time or the training to ask you how you are.

I understand your frustrations OP, however she’s not there to be compassionate imo, she did her job. If you or anyone else needed to be seen sooner, then a simple “that’s no good, I need urgent help” “I feel suicidal” or whatever, would suffice to then be dealt with differently. Im sorry you’re struggling, sending you best wishes and I hope you improve soon 💐

I am sorry you are feeling both poorly and upset but this might be something that helps you in the long run - because I think it has really highlighted for you three things:

1. I think you might be being very stiff up a lip about your depression and masking how you really feel to the outside world and you need to practice expressing how you really feel externally. My teen daughter is on high dose antidepressants and I think 'tweaking' is not a word someone with severe depression would use to describe their mood. I am not saying you don't have severe depression - in fact I suspect you do - I am saying you are not being upfront with it externally.
2. Its clear you want help - your upset because a random stranger did not console you. That's OK, again not a criticism I just want to point out to you that your thoughts are suggesting you really want help so please ask for it.
3. re the secretary - it might be a new thing for you but its very common for people to regularly increase their antidepressants as they need to do that to get the right dose. For my daughter I email her psychiatrist saying I think she needs to increase her dose can I have an appointment - and I can wait for a few weeks. This time I waited for 4 weeks.
4. I must admit I was hesitant to put my daughter on antidepressants and then I was Ok about her being on a low dose as she was 'coping' but after a long period of time I realised she needs to do more than just 'cope' with life she needs to live her best life and so we have quite dramatically increased the dose regularly and will continue to do so until life for her becomes enjoyable again; until laughter is a regular feature in her day. The idea is you get into a rhythm of enjoying life and then you consider reducing them. I think you need to rethink your approach to antidepressants - if I was to give you antibiotics for an infection - would you just want to take a low dose to keep the infection at bay or would you want to take the right amount to get rid of it? You are on them for a reason - please consider getting them to the right level so they can properly help you however high that dose it. One of the my biggest regrets in life is not doing this for my daughter and letting her spend years just coping.

I am sorry you are having such a hard time. I hope things gets better.

In terms of the receptionist, maybe it could be helpful to depersonalise the experience a bit. You’ve been thinking about your deteriorating mental health for a while and the call and the mention of antidepressants was a culmination of a lot of rumination. For the receptionist, you were one of the many hundreds of people who need to speak to the GP about their mental health - around 30% of GP patients are experiencing mental health issues. From the point of view of the receptionist, your call was routine, even if it took months of deliberations and self help for you. Let’s say she takes 6 callers every hour, 42 per day - 14 of her interactions will be about mental health. I know you are in crisis but she wasn’t unfeeling - just told you when you can next speak to the GP.

I wish you all the strength and lots of help along the way.

I have recently been a GO receptionist and I'm sorry but no we aren't allowed to lead on questions like that we can of course offer our sympathies and ask if you are ok however we can't ask if it's a emergency etc you have to say if you feel there are negative thoughts / harm to yourself or others etc

I once rang my GPs surgery and said l was having suicidal thoughts.
"We've got no appointments today. You'll have to ring back in the morning".
"I'm really depressed. Very low. And l have a family history of suicide, my mother too her own life."
"We've got no appointments today. Call back at 8 o'clock."
Good thing l'm still here....

That's shocking. I'm sorry. How are you now?

In this day the receptionists are trained to triage so I would expect them to ask actually and then sign post to the crisis team or other support while you wait for the appointment. I’m guessing the other posters who think this is your fault aren’t aware of how services are running at the moment (I work with gps in my role and support the services so I’d be disappointed if it was a receptionist in our county).

GoodChat I'm fine now, thank you for asking. I talked to a good friend that day and they were very supportive.
I'm very angry when l think about it now, though. I couldn't have made things more clear, but was summarily dismissed.
My mother took her own life when she was 83. Also with a history of depression going back to when she was 17.