LETTER: Mental health care requires psychiatry and counselling

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I AM a GP fundholder with both counselling and psychology services available in my surgery. I also have an attached community psychiatric nurse and refer patients to consultant psychiatrists when necessary.

Contrary to what is suggested in your article "Worried well force aside the mentally ill" (10 December), GPs are uniquely placed to judge what constitutes appropriate care and should be able to diagnose serious depression, as distinct from marital problems, before arranging referral to the best service for that patient. Resources have never been diverted by GP fundholders in that respect. What used to happen was that people with unhappy lives (the "worried well") were referred to psychiatrists, treated with drugs to mask their problems and seen infrequently. These patients no longer see psychiatrists (thus freeing up the psychiatrists' time to deal with psy- chotic patients) and are helped to deal with their problems.

Dr Jean Quinn

Wirral, Merseyside

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