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Rising numbers of patients with anxiety and depression are not the only cases of serious illness expected to balloon in the next two decades, with most big conditions, from cancer to chronic pain, expected to rise

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The number of people suffering from anxiety or depression is set to soar in the next two decades and could overwhelm GPs and community care nurses UK-wide, experts have warned.

A new study from the Health Foundation think-tank forecasts that cases of anxiety or depression will jump by 575,669, or 16 per cent, between 2019 and 2040, by which point 4.23 million people in England would be suffering from one or both conditions.

The rest of the UK is likely to see broadly similar increases, researchers suggested.

The projected increase comes as the system is already struggling to treat existing cases. Nearly one in four are being forced to wait more than 12 weeks to start treatment for anxiety, depression and other mental illnesses, according to a separate study by The Royal College of Psychiatrists.

That study also found that 43 per cent of adults with mental illness say the long waits for treatment have led to their mental health getting worse.

Some of the increase in diagnoses highlighted in the new Health Foundation report is likely to be because more attention is paid to mental health issues today than a decade and more ago, researchers said.

But a significant part of recent and projected rises is thought to be driven by factors such as financial concerns and job insecurity, social media use and increased difficulty sleeping – as well as mental health issues stemming from the rising number of physical illnesses, which can take their toll emotionally.

There have also been reports that stress from the pandemic has made an ongoing contribution to elevated anxiety and depression rates.

The rise in diagnoses will significantly increase the numbers of patients needing primary care, as it is GPs and community care services which typically diagnose and treat patients for depression and anxiety, according to Toby Watt, lead author of the Health Foundation study.

It would also put further pressure on friends and family, who provide support for many, he adds.

Professor Kamila Hawthorne, chair of the Royal College of GPs, agrees that the increase in anxiety and depression cases would put further pressure on a system already under pressure.

“GP teams are currently working under intense workload and workforce pressures – and this must be addressed as a matter of urgency.”

“Ultimately, the effective treatment of patients with mental health concerns relies on a robust primary care system that has the capacity to respond to the increasing mental health needs of our patients,” she told i.

Meanwhile, Mr Watt says that after years of underinvestment, the primary health system is already reeling.

Asked whether an increase of this magnitude in depression and anxiety patients could potentially overwhelm it, he said: “Yes, for sure.”

“Primary care is already under huge amounts of pressure. Anxiety and depression is growing and that is a big part of what GPs and primary care staff do – help people with issues relating to anxiety and depression.

“The other conditions that are growing even quicker, such as chronic pain and diabetes, are also largely managed in primary care. And often patients with severe health needs and multiple conditions will also have issues relating to anxiety and depression as well – so all of this paints a fairly stark picture for primary care and reinforces the need to make sure we’ve got an effective workforce plan for primary care but also investment in primary care and community services.”

“We need to train a lot more primary care staff. And we need to make primary care an attractive place to work so the supply of people who are wanting to engage in that training and become GPs and primary care nurses. We’ve been referring to this as the kind of ‘bathtub of staff’ – the long term workforce plan is turning the tap on, trying to get more people to work in primary care but we need to make sure that the plug is in at the bottom to make sure that retention rates in primary care are sufficient to manage the increase in demand that we’re seeing here,” Mr Watt says.

He argues that primary care has often taken second place to hospitals when it comes to funding and attention.

The study also shows we should be focusing more on prevention and early intervention to reduce the impact of illness and improve the quality of people’s lives, he points out.

The research on depression and anxiety cases is part of a bigger study which found that the number of people living with major illness is projected to increase by 37 per cent by 2040.

That is nine times the rate at which the working age population – 20–69-year-olds – is expected to grow (4 per cent).

Professor Hawthorne, of the RCGP, added: “GPs have certainly seen an increase in patients presenting with mental health conditions in recent years, and as this report shows, this is projected to continue. While it’s concerning that more people appear to be suffering with poor mental health, an increase in cases of anxiety and depression could also signify greater societal openness to discussing mental health and a reduced stigma in asking for help.”

“Caring for patients with mental health conditions, and appropriately referring to specialist services, is something GPs and our teams take very seriously. But to give patients with mental health conditions the care they need, we need more time – the standard 10-minute consultation is simply not long enough if we want patients to receive the help they really need and deserve.

“It’s also the case that access to specialist mental health services in the community can be patchy across the country – and in some cases, referrals are sometimes bounced back – meaning that patients often have to wait too long to get the help they need,” she said.

Gemma Byrne, policy and campaigns manager at Mind, says: “We know the cost-of-living crisis is taking a huge toll on people’s mental health. Years of underinvestment have left our mental health services struggling to keep up with the demand for support. The result is that too many people see their mental health get worse before they can access any help.

“There is plenty the UK government can and should be doing to better support the nation’s mental health now and into the future. This includes focusing on prevention and addressing issues such as poverty, discrimination, and employment that so closely affects people’s mental health.

“Alongside this, we need to urgently see investment in mental health services to build a system fit for purpose where people can get the right support when they first need it.”

“Our mental health is affected by many factors including our environment, relationships, employment, and housing, making it difficult to predict future trends. In less than a decade we have now seen a sharp increase in the prevalence of mental health problems among young people. In 2017, one in 10 young people aged 17-19 experienced a mental health problem, but in 2022 this increased to one in four people,” she said.

A Department of Health and Social Care spokesperson said: “We are spending an extra £2.3 billion a year by March 2024 to improve mental health services so an additional two million people can access mental health support. This will ensure the NHS is fit for the challenges of today and for the future.

“Our forthcoming Major Conditions Strategy will also outline how best to prevent, diagnose, and manage mental ill-health – as one of six key elements – after we committed £39 billion in the last year to recover from Covid, cut waiting lists and put health and care services on a sustainable footing.”

An NHS spokesperson said: “Thanks to NHS staff, record numbers of people have been accessing mental health services, and we continue to grow capacity in our world-leading talking therapy services, with nine in ten patients accessing talking therapies within 6 weeks of referral in March 2023 – well above the 75 per cent target.

“By offering people the choice of a face-to-face, phone or online appointment, and expanding services and modes of delivery, more people are able to access talking therapies for anxiety and depression, and we will continue to work with systems to ensure we provide the best access and treatment for people who need mental health support.”

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