As millions of people in England and Wales rely on their GP for mental health support, a significant trend is emerging: despite an increase in symptoms of depression and anxiety, the number of formal diagnoses remains stable. A recent study published in the Journal of Epidemiology & Community Health has shed light on this phenomenon, analysing 14 years' worth of data from primary care in Norway.
According to Professor Stella Chan, Charlie Waller Chair in Evidence-Based Psychological Treatment at the University of Reading, the study's robust methodology is a major strength. "By using extensive administrative data, we can identify trends that might be masked by smaller studies," she explains. However, she also cautions that while the findings are intriguing, they shouldn't be taken to mean that mental health in Norway (or elsewhere) is improving – at least, not without further investigation.
Experts point out that there could be several reasons for this discrepancy between symptom presentations and diagnostic rates. "It's possible that people are more willing to come forward with their symptoms," suggests Professor Celso Arango, Chair of the Child and Adolescent Department of Psychiatry at Hospital La Paz, CIBERSAM. Alternatively, GPs may be opting for less stigmatising language in their records, or referring patients using symptom codes rather than formal diagnoses.
These insights are not new to the field – researchers have been observing this trend for over a decade. Javier José Pérez Flores, a lecturer in the Department of Psychobiology at the University of La Laguna, notes that similar patterns have emerged in other countries, including the UK, where anxiety symptoms have seen a notable increase without a corresponding rise in formal diagnoses.
The NHS is already working to address this growing demand for mental health services. The Long Term Plan aims to expand access to talking therapies and other forms of support, acknowledging that primary care will play a vital role in delivering these services – especially given the rising number of people seeking help for their mental wellbeing.