Bold claim first: mental health isn’t simply a checkbox to tick; it’s a complex, society-wide issue that affects millions and often goes unmet. But here’s where it gets controversial… many GPs in England question whether normal life stresses are being medicalised into mental health diagnoses, even as they acknowledge the toll of insufficient support for those truly in need.
Hundreds of GPs across England have voiced concerns to the BBC that mental health problems may be over-diagnosed, while also highlighting barometers of under-service that leave patients without timely help. Our reporting gathered responses from more than 5,000 GPs, with 752 participating and 442 expressing worry about over-diagnosis. A smaller group, 81 clinicians, felt mental health conditions were under-diagnosed.
In addition to concerns about over-diagnosis, many practitioners flagged gaps in access to care. Anonymous comments from the survey reveal a prevailing sentiment: life’s pressures do not automatically equate to illness. One GP summed it up by saying, “Life being stressful is not an illness.” Another stressed that society has forgotten that grief and heartbreak can be painful yet normal, necessitating coping strategies in addition to medical help. A further view argued that labeling conditions like anxiety or depression can over-medicalise ordinary emotional struggles, diverting resources away from those with severe needs.
There were also sharper criticisms: a minority of GPs described some patients as dishonest or manipulative, attempting to game a system designed to be free at the point of use. These remarks underscore the complexity and potential bias within clinical assessments.
Statistical context matters too. NHS England surveys show about 1 in 5 adults report a common mental health condition such as anxiety or depression, with higher rates among young people (roughly 1 in 4 for ages 16–24). The GPs in our study pointed to 19–34-year-olds as the group most in need of mental health support, with some suggesting that post-pandemic resilience has waned among young adults who may pursue diagnoses as a pathway to care rather than focusing on coping skills.
Others, however, argued the opposite: that under-diagnosis persists, leaving many without timely help. A clinician noted that people must be accepted, supported, and encouraged to live life, while another described services as reluctant to fully assess and diagnose patients who need help.
The pool of respondents included nearly 40,000 fully qualified GPs in England, but the study cannot confirm that the participants represent all family doctors. When asked about changes in time spent on mental health, almost all respondents who had been in practice at least five years reported an increase, driven by three main factors:
- Helping patients who cannot access quality mental health services elsewhere
- Practical issues such as housing, employment, and finances affecting mental health
- Patients perceiving themselves as having a mental health issue while dealing with ordinary life challenges
Earlier this year, Health Secretary Wes Streeting suggested to BBC interviewer Laura Kuenssberg that mental health conditions were over-diagnosed and that too many people were being written off. He later described those comments as divisive, acknowledging the complexity of the topic.
The broader reality remains contested and multifaceted. Some estimates suggest 2.5 million people in England may have ADHD, including undiagnosed individuals, and service capacity has been strained, with some ADHD services restricting new patients due to demand. Patients have reported difficulty obtaining appropriate care and support.
A clear majority of GPs in our survey (508 of 752) said that there is rarely or never enough good-quality adult mental health care in their area. Even more (640 GPs) worried about getting adequate help for younger patients. One clinician called mental health support a “national tragedy,” while another warned that a crisis point can arrive when a patient’s risk is not taken seriously unless a severe cue is present.
Regarding medication, many GPs reported prescribing antidepressants as a stopgap when timely access to talking therapies or other supports may be delayed. One doctor admitted reaching for antidepressants even when they knew this might offer only short-term relief and not prevent recurrence.
Professor Victoria Tzortziou Brown, chair of the Royal College of GPs, emphasized the delicate balance doctors must strike. Diagnoses should not be made to fit every moment of distress, yet genuine mental health concerns should not be dismissed as over-diagnosis. The aim is to align clinical judgment with patient needs, without medicalising ordinary life experiences or neglecting those with true conditions.
An independent review into rising demand for mental health services is expected to listen to all evidence and provide recommendations that are genuinely useful for improving care.
Additional reporting by Phil Leake.
