Can a self-referral system help improve access to psychological treatments?
Open accessAbstract
Referrals for psychological treatment have been problematic for many years. Even though GPs have attempted to limit access into the small psychological treatment services, long waiting lists have developed which have deterred referrals and deferred psychological care. GPs have understandably been frustrated. In addition, the consultation rate for psychological problems is low when compared with the rate of identified mental health problems in population surveys. Possible reasons include patients' failure to recognise the problem as psychological and thus not consulting one's GP, and/or the problem not being detected by the GP. While a self-referral system may be seen as a way of trying to allow non-consulters to receive treatment, this has been viewed with some scepticism since it may allow the 'worried well' to access already limited services. However, a study has shown that those self-referring to advertised psychological workshops had high levels of psychological morbidity and also were more representative of the population, in terms of ethnicity, than GP referrals. The government has set up the Increasing Access to Psychological Therapies (IAPT) programme to address some of the service shortfalls by expanding the provision of psychological therapists. Notably, the IAPT programme is allowing self-referrals such that any member of the public can access the service directly, bypassing general practice. Although not available at all the sites, this represents a radical shift from the present system in which access to talking therapy is generally only available through direct referral by the GP. The implications of this new development are discussed.
AI snapshot
Written from the paper’s full text.
TL;DR
This discussion paper argues that self-referral can improve access to psychological treatments, particularly for people who do not consult their GP or are not detected by them. It reviews evidence from psycho-educational workshops and the Newham IAPT demonstration site, concluding that self-referral needs extra capacity and gatekeeping but may reach underserved groups.
Key findings
- About 70% of people with mental health problems do not present to their GP, according to the National Psychiatric Morbidity Survey cited in the paper.
- In self-referral psycho-educational workshops, almost three-quarters of participants met criteria for ICD-10 diagnoses, mean anxiety and depression scores were well above average, and almost one-third had never previously consulted their GP about emotional problems.
- At the Newham IAPT demonstration site, 203 people (22.8%) self-referred and 688 (77.2%) were GP-referred; in the final 3 months, the proportion of self-referrers increased to 42%. GP and self-referrals did not significantly differ in severity, but self-referrals more closely matched the community ethnic mix and were significantly more likely to be from black and minority ethnic groups; social phobia and OCD were significantly more common among self-referrals.
- The IAPT programme was launched with £300 million to train 3600 new therapists over 3 years, approximately one-third of the estimated 10 000 required.
Methods
- Design: discussion/review paper examining reasons for poor access to psychological treatments and the potential value of self-referral.
- Data/sample: draws on published literature and two service examples — large-scale community psycho-educational CBT workshops in Camberwell, south-east London, and the Newham IAPT demonstration site.
- Main analysis: narrative synthesis of evidence and service examples; no formal systematic search, meta-analysis, or primary data collection is described.
Limitations
- The authors state that the cost-effectiveness of self-referral needs evaluation and that it is not clear whether the Newham self-referral rate will be maintained in the long run.
- The authors note possible disadvantages: people with relatively minor problems, or more vocal and articulate participants, may overuse limited services, so gatekeeping mechanisms are needed.
- Evident from the text: some claims rely on personal communications and anecdotal reports, and the paper does not describe a systematic review methodology.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 43 cited sources checked · 0 supported · 0 flagged
- Premisecitation
Almost one-third of self-referrers to the 'stress and self confidence' workshops had never previously consulted their GPs about their emotional problems.
“Perhaps most fundamentally, almost onethird of self-referrers to the 'stress and self confidence' workshops had never previously consulted their GPs about their emotional problems.50”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] source
Not checked in the free run.
- Premisecitation
Patients' reluctance to consult their physicians is related to how people believe their GPs will respond if they were to present with a mental health problem.
“Several studies have reported that patients' reluctance to consult their physicians is related to how people believe their GPs will respond if they were to present with a mental health problem.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11] source
Not checked in the free run.
- Premisecitation
Even if patients consult their GP, mental health problems may not always be detected.
“Even if patients do consult their GP, problems may not always be detected.Shortcomings in clinicians' skills in detecting mental health problems have been commonly reported.1,8”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [1] Goldberg D Huxley P (1992) Mental illness in the community: the pathway to psychiatric care (Tavistock, London).
Not checked in the free run.
- cites [8] source
Not checked in the free run.
- Premisecitation
Some ethnic groups, such as Africans and Asians, are less likely to consult their GPs for mental health problems.
“However, some ethnic groups are less likely to consult their GPs, as occurs with Africans 39 and Asians.40”
Quote in the paperNot a substantial claim0 of 2 sources checked - Premisecitation
Stigma operates as a major barrier to help seeking for mental health problems.
“Given these widely held social attitudes, it is not surprising that several studies suggest stigma operates as a major barrier to help seeking.25,26”
Quote in the paperSubstantial claim0 of 2 sources checked
- Premisecitation
Many people view mental health problems as something they need to manage by themselves, rather than medicalise the problem by consulting the doctor.
“Many people view mental health problems as something they need to manage by themselves, rather than medicalise the problem 30 by consulting the doctor.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [30] source
Not checked in the free run.
- Premisecitation
Even when people from ethnic minority groups attend their GP, detection rates for mental health problems are lower.
“Even when people do attend their GP, detection rates for mental health problems are lower in ethnic minority groups.41,42”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationcitation
Organising services with multiple levels of entry and service delivery, rather than a single referral gateway at primary care, may help increase access to psychological therapies.
“Organising services with multiple levels of entry and service delivery, rather than the more traditional single referral gateway at the level of primary care into secondary care services, may help to increase access to psychological therapies.3”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Lovell, 2000, Multiple access points and levels of entry (MAPLE): ensuring choice, accessibility and equity for CBT services, Behav Cogn Psychother source
Not checked in the free run.
- Premisecitation
Black African women in London who had suffered depression thought depression was less serious, more short-lasting and less amenable to treatment compared with white British women.
“A recent study of the attitudes of black African women in London who had suffered depression found that they thought depression was less serious, more short-lasting and less amenable to treatment compared with white British women.39”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [39] Brown JSL Bishop AJ Prytys M (2010) How black African and white British women perceive depression: a pilot vignette study. Int J Soc Psychiatry, doi:10.1177/0020764009357400. source
Not checked in the free run.
- Premisecitation
In the National Psychiatric Morbidity Survey, the most common response to how people deal with mental health problems was to try to cope with problems oneself.
“Meltzer et al reported in the National Psychiatric Morbidity Survey, that the most common response to how people deal with mental health problems was to try to cope with problems oneself.32”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [32] source
Not checked in the free run.
- Premisecitation
In the final 3 months of the Newham evaluation, the proportion of self-referrers increased to 42%.
“In the final 3 months of the evaluation, the proportion of selfreferrers had increased to 42%.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [47] source
Not checked in the free run.
- Premisecitation
The workshops appealed to groups traditionally difficult to engage in services, such as the unemployed and people from black and minority ethnic groups.
“They also appeal to groups that are traditionally more difficult to engage in services, such as the unemployed and people from black and minority ethnic groups.50”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [50] source
Not checked in the free run.
- Interpretationown data
The self-referral system is successfully reaching those in need, as indicated by high morbidity among self-referrers to workshops.
“suggesting that the self-referral system is successfully reaching those in need.”
Quote in the paperSubstantial claim - Premisecitation
There is evidence that GPs are rational decision makers when referring for psychological therapies.
“Relevant to this, there is also evidence to show that GPs are rational decision makers when referring for psychological therapies.53”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [53] Stavrou, 2009, Decisions about referrals for psychological therapies: a matched-patient qualitative study, Br J Gen Pract source
Not checked in the free run.
- Interpretationreasoning
Using non-diagnostic labels of 'stress and self-confidence' enabled people with problems of depression and anxiety to receive help that fitted more with how they saw their problems as due to problems of living.
“It is argued that using non-diagnostic labels of 'stress and self-confidence' enabled people with problems of depression and anxiety to receive help that fitted in more with the way in which they saw their problems as due to problems of living, such as work and relationship problems.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Self-referral can attract people who might not otherwise reach services.
“As well as allowing easier access, it can attract people who might not otherwise reach services.”
Quote in the paperSubstantial claim- Rests on an assumption: The findings from the psycho-educational workshops and the Newham IAPT demonstration site are generalisable to other self-referral services and to the national IAPT programme.
- Rests on an assumption: People who do not consult their GP for mental health problems would be willing to use a self-referral route if it were available.
- Premisecitation
In the Newham evaluation, GP referrals and self-referrals did not significantly differ in the severity of their psychological problems.
“One key finding of the evaluation was that GP referrals and self-referrals did not significantly differ in the severity of their psychological problems.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [47] source
Not checked in the free run.
- Interpretationnone given
The introduction of a self-referral route can open up pathways to care, enabling people to access services of their choice without first having to consult their GP.
“The introduction of a self-referral route can be used to open up pathways to care, enabling people to access services of their choice without first having to consult their GP.”
Quote in the paperSubstantial claim- Rests on an assumption: People who do not consult their GP for mental health problems would be willing to use a self-referral route if it were available.
- Premisecitation
In the Newham evaluation, social phobia and obsessive compulsive disorder were significantly more common among self-referrals than among GP referrals.
“Another finding of note was that social phobia and obsessive compulsive disorder (OCD) were found to be significantly more common among self-referrals than among GP referrals.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [47] source
Not checked in the free run.
- Classified as probably not a substantial claim. 10
- May combine two claims. 19
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Department of Health developed the Improving Access to Psychological Therapies (IAPT) programme to increase public access to effective psychological therapies for common mental health problems.
“In response, the Department of Health has developed the Improving Access to Psychological Therapies (IAPT) programme, 6 which aims to increase public access to effective psychological therapies for common mental health problems.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] Department of Health (2008) Improving Access to Psychological Therapies (IAPT) Commissioning Toolkit (Department of Health, London) http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_084065 (accessed 25 Feb 2010).
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationSelf-referral psycho-educational CBT workshops were originally set up in Birmingham and further developed in south-east London.
“Self-referral psycho-educational CBT workshops were originally set up in Birmingham and further developed in south-east London.46,48”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationCommon mental health problems, mainly anxiety and depression, form a large proportion of GPs' daily workload, and psychological therapies play a large part in their first-line management.
“Common mental health problems, mainly anxiety and depression, form a large proportion of the daily workload of GPs, 1 and psychological therapies play a large part in their first-line management. 2”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [1] Goldberg D Huxley P (1992) Mental illness in the community: the pathway to psychiatric care (Tavistock, London).
Not checked in the free run.
- cites [2] National Institute for Clinical Excellence (2009) Depression: the treatment and management of depression in adults: update (NICE, London).
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe IAPT programme aims to train 3,600 new therapists over 3 years with an investment of £300 million, approximately one-third of the 10,000 required.
“With an investment of £300 million, it aims to train 3600 new therapists over 3 years, approximately one-third of the 10 000 required, with the aim of creating more accessible therapy services.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] Department of Health (2008) Improving Access to Psychological Therapies (IAPT) Commissioning Toolkit (Department of Health, London) http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_084065 (accessed 25 Feb 2010).
Not checked in the free run.
May combine two claims.
PremisecitationAbout 70% of people with mental health problems do not present to their GP and therefore do not have access to psychological therapy.
“However, it may address a key finding from the National Psychiatric Morbidity Survey that about 70% of people with mental health problems do not present to their GP and therefore do not have access to psychological therapy.7”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] source
Not checked in the free run.
May combine two claims.
PremisecitationMean delays of 8 years and 9.4 years have been found for depression and anxiety problems before consulting GPs.
“Mean delays of 8 years 9 and 9.4 years 10 have been found for depression and anxiety problems.”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThompson et al found that the most common reasons for not consulting were 'I thought it would go away by itself' (27.2%) and 'I thought nothing could help' (17.3%).
“Thompson et al found that the most common reasons for not consulting were 'I thought it would go away by itself' (27.2%) and 'I thought nothing could help' (17.3%).10”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [10] Thompson, 2004, Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample, Soc Psychiatry Psychiatr Epidemiol source
Not checked in the free run.
May combine two claims.
PremisecitationA cross-sectional analysis of participants who self-referred to psycho-educational workshops revealed that almost three-quarters met criteria for ICD-10 diagnoses and had mean anxiety and depression scores well above average.
“While self-referral systems have been criticised for simply attracting the 'worried well', 49 a crosssectional analysis of participants who did self-refer to these psycho-educational workshops revealed that almost three-quarters met criteria for International Classification of Diseases (ICD)-10 diagnoses, and had mean anxiety and depression scores well above average, 50 suggesting that the self-re”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationMore than 10,000 new therapists have been estimated to be required to expand evidence-based treatments for depression and anxiety.
“For this to happen, it has been estimated that more than 10 000 new therapists will be required.5”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] Layard R (2006) The case for psychological treatment centres, http://cep.lse.ac.uk/layard/psych_treatment_centres.pdf (accessed 25 Feb 2010).
Not checked in the free run.
May combine two claims.
PremisecitationIAPT services offer the option of self-referral, enabling people with self-defined mental health problems to access mental health services directly, bypassing the need for GPs to always refer them.
“Significantly, these new IAPT services will offer the option of self-referral.This enables people with selfdefined mental health problems to access mental health services in relatively large numbers, thus bypassing the need for GPs to always refer them.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Department of Health (2008) Improving Access to Psychological Therapies (IAPT) Commissioning Toolkit (Department of Health, London) http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_084065 (accessed 25 Feb 2010).
Not checked in the free run.
May combine two claims.
PremisecitationPsychological therapies have usually offered one-to-one interventions to relatively few patients ('high contact, low volume'), whereas primary care services have offered short appointments to a large number of patients ('low contact, high volume').
“In addition, while primary care services have offered short appointments to a large number of patients, described as 'low contact, high volume' services, 4 psychological therapies have usually offered oneto-one interventions to relatively few patients, these being described as 'high contact, low volume' interventions. 4”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [4] France, 1995, Behavioural cognitive therapy in the primary care setting: issues of organization, Clin Psychol Forum source
Not checked in the free run.
May combine two claims.
PremisecitationPeople with depression have tended to be seen as more emotionally unstable, less worthy of sympathy, and responsible for causing their own problems compared with people with physical health problems.
“When compared with people with physical health problems, people with depression have tended to be seen as more emotionally unstable, less worthy of sympathy, and responsible for causing their own problems.[20][21][22]”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [20] source
Not checked in the free run.
- cites [21] Wadley, 2001, Diagnostic attributions versus labelling: impact of Alzheimer's disease and major depression diagnoses on the emotions, beliefs, and helping intentions of family members, J Gerontol Psychol Sci source
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- cites [22] source
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May combine two claims.
PremisecitationAccess to psychological treatment services for individuals with common mental health problems has often been variable and limited, with long waiting lists.
“However, because of their low capacity, access to psychological treatment services for individuals with these difficulties has often been variable and limited, with long waiting lists for these services.3”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Lovell, 2000, Multiple access points and levels of entry (MAPLE): ensuring choice, accessibility and equity for CBT services, Behav Cogn Psychother source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
InterpretationreasoningThe authors believe that the self-referral route has major advantages for improved access to those who would otherwise not receive services.
“In conclusion, the authors believe that the selfreferral route has major advantages for improved access to those who would otherwise not receive services.”
Quote in the paperNot a substantial claim- Rests on an assumption: The findings from the psycho-educational workshops and the Newham IAPT demonstration site are generalisable to other self-referral services and to the national IAPT programme.
- Rests on an assumption: People who do not consult their GP for mental health problems would be willing to use a self-referral route if it were available.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.
InterpretationreasoningSelf-referral could work out extremely well and improve access for those who may not have been able to get access before, as well as those who have never thought of consulting.
“Given this, it could work out extremely well and improve access for those who may not have been able to get access before, as well as those who have never thought of consulting.”
Quote in the paperNot a substantial claim- Rests on an assumption: The findings from the psycho-educational workshops and the Newham IAPT demonstration site are generalisable to other self-referral services and to the national IAPT programme.
- Rests on an assumption: People who do not consult their GP for mental health problems would be willing to use a self-referral route if it were available.
May combine two claims.
PremisecitationThe workshops attracted people from a range of backgrounds and appeared equally effective for self-referrers from differing areas of deprivation.
“Additionally, these workshops have been shown to attract people from a range of backgrounds and they appear to be equally effective for self-referrers from differing areas of deprivation.48”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [48] Brown, 2006, Can large-scale self-referral psycho-educational stress workshops help improve the psychological health of the population?, Behav Cogn Psychother source
Not checked in the free run.
May combine two claims.
PremisecitationIn the Newham evaluation, self-referrals had a slightly longer duration of their conditions (7.5 years versus 6.9 years), but this difference was not statistically significant.
“Finally, while self-referrals had a slightly longer duration of their conditions (7.5 years versus 6.9 years), this difference was not statistically significant.47”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [47] source
Not checked in the free run.
May combine two claims.
PremisecitationAmong self-referrers to the workshops, those who had consulted their GP were significantly more distressed and depressed than those who had not consulted, but non-consulters' distress and depression scores were still well above clinical thresholds.
“Those who had consulted their GP were significantly more distressed and depressed than those who had not consulted but, nevertheless, the distress and depression scores of non-consulters were still well above the clinical thresholds.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] source
Not checked in the free run.
May combine two claims.
InterpretationcitationThe self-referral service may facilitate access to those who are particularly difficult to reach and contributes to a more equitable NHS.
“Given the government's commitment to 'promote mental health for all and combat discrimination against individuals and groups with mental health problems and promote their social inclusion', as asserted in the National Service Framework for Mental Health, 51 this self-referral service may facilitate access to those who are particularly difficult to reach, and contributes to a more equitable NHS.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [51] Department of Health (1999) National Service Framework for Mental Health: modern standards and service models (Department of Health, London).
Not checked in the free run.
- Rests on an assumption: The findings from the psycho-educational workshops and the Newham IAPT demonstration site are generalisable to other self-referral services and to the national IAPT programme.
May combine two claims.
PremisecitationIn the Newham IAPT demonstration site, 203 people (22.8%) self-referred and 688 (77.2%) were referred by GPs.
“While the Doncaster site decided not to offer self-referral as an option, the Newham service did offer a selfreferral route and 203 people (22.8%) self-referred and 688 (77.2%) were referred by GPs.47”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [47] source
Not checked in the free run.
Probably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenSelf-referral may have disadvantages, including that people with relatively minor problems, or more vocal and articulate participants, may overuse limited services.
“Self-referral may also have disadvantages.People with relatively minor problems, or more vocal and articulate participants, may overuse limited services.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationnone givenThe self-referral system needs to be linked to extra capacity, either through large-scale interventions or through the IAPT programme.
“It is clear the self-referral system does need to be linked to extra capacity, either through large-scale interventions or through the IAPT programme.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationIn the Newham evaluation, those who referred themselves more closely matched the ethnic mix of the community and were significantly more likely to be from black and minority ethnic groups than other referrals.
“Second, those who referred themselves more closely matched the ethnic mix of the community and were significantly more likely to be from black and minority ethnic groups than other referrals.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [47] source
Not checked in the free run.
The paper relies on this without support.
The findings from the psycho-educational workshops and the Newham IAPT demonstration site are generalisable to other self-referral services and to the national IAPT programme.
“These two services can illustrate the value of self-referral pathways for psychological therapies.”
The paper relies on this without support.
People who do not consult their GP for mental health problems would be willing to use a self-referral route if it were available.
“However, it may address a key finding from the National Psychiatric Morbidity Survey that about 70% of people with mental health problems do not present to their GP and therefore do not have access to psychological therapy.7”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the United Kingdom, the NHS Talking Therapies program predominantly relies on self-referrals.
“In the United Kingdom, the NHS Talking Therapies for Anxiety and Depression program -formerly Improving Access to Psychological Therapies (IAPT)predominantly relies on self-referrals [Brown et al., 2010, The National Collaborating Centre for Mental Health, 2021].”
From Closing the accessibility gap to mental health treatment with a personalized self-referral chatbot (2024) · cites this paper as Brown et al., 2010
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
IAPT programme name differs between the abstract and introduction
MinorThe abstract calls IAPT "Increasing Access to Psychological Therapies," while the introduction calls it "Improving Access to Psychological Therapies."
“The government has set up the Increasing Access to Psychological Therapies (IAPT) programme”
“the Department of Health has developed the Improving Access to Psychological Therapies (IAPT) programme”
Newham evaluation citation points to a workshops paper
MinorThe Newham self-referral figures are attributed to reference 47, but reference 47 is titled as a study of self-referral stress workshops, not the Newham demonstration-site evaluation.
“the Newham service did offer a selfreferral route and 203 people (22.8%) self-referred and 688 (77.2%) were referred by GPs.47”
“47. Brown JSL, Elliot SA, Butler C. Can large-scale self-referral psycho- educational stress workshops help improve the psychological health of the population? Behav Cogn Psychother 2006; 34: 165-177.”
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- Authors
- Brown, J. S., Boardman, J., Whittinger, N., & Ashworth, M.
- Affiliations
- King's College London (GB)
- University of London (GB)
- Venue
- British Journal of General Practice
- Published
- 2010-05-01
- Volume
- 60
- Issue
- 574
- Pages
- 365-371
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC2858533
- OpenAlex
- W2137060139
- Semantic Scholar
- ef33c269844c556164b4c23a0112d579dab29895
- Cited by
- 49
- References
- 51
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 5 · 2023: 2 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 5 · 2013: 3 · 2012: 1
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- British Journal of General Practice (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research
- King's College London
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Services Management and Policy
- Keywords
- self-referral, access to psychological treatment, waiting lists, general practitioner referral, psychological morbidity, worried well, mental health service utilization
- MeSH terms
- Attitude to Health, Mental Disorders, Family Practice, Health Services Accessibility, Humans, Physician-Patient Relations, Psychotherapy, Referral and Consultation, Self Care, Stereotyping, General Practice
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.
Statistics and arithmetic are recomputed, not judged.
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