The study argues that over-stretched GP services are frequently unable to offer the level of care needed by people with mental illness.

Too many people are not properly diagnosed Dr Matt Muijen

The report, by the Sainsbury Centre for Mental Health in association with the NHS Alliance, paints a grim picture.

It says many primary care staff lack training in mental health, and links with specialist services are often poor.

The result is that too many mental health problems are not diagnosed properly and that some patients receive inappropriate medication.

Yet the report shows that innovative approaches to primary mental health care do exist and can work:

• In Ipswich, for example, practice nurses are able to advise and treat patients diagnosed with mental illnesses.
• In Bradford, a dedicated team of primary care staff runs a clinic for people who do not need specialist care but whose problems are too complex to be managed by their GP.

More than 90% of people with mental illnesses never have contact with specialist services, and are only ever treated in primary care.

But research has suggested that up to half those who present themselves to a general practice with depression and other mental health problems fail to have their mental health symptoms recognised by the GP.

Dr Matt Muijen, chief executive of the Sainsbury Centre, said: "For people with a mental health problem, a timely diagnosis by their family doctor is a vital beginning on the road to recovery. Yet too many people are not properly diagnosed.

With the right skills and the right resources, GPs can ensure people with mental health problems are diagnosed correctly Dr Ron Singer NHS Alliance

"As a result, they not only experience avoidable misery, they may be forced to take time off work, school or college at a massive cost both to their families and to the economy as a whole."

He called for greater investment in primary care.

"Good quality primary mental health care is not merely good for patients; it is also very good value for taxpayers' money."

Dr Ron Singer, of the NHS Alliance, said: "General practice is at the heart of the health service.

"Up to one quarter of people suffer from a mental illness every year, and most of them will see their GP during that time.

"With the right skills and the right resources, GPs can ensure people with mental health problems are diagnosed correctly and given the treatment they need close to home."

Crisis warning

Shadow Health Secretary Dr Liam Fox said: "This report reaffirms what the Conservatives have been warning of for some time. Mental health is in crisis.

"People are working heroically and tirelessly to look after those with mental health problems and keep the system going but are receiving no support from the government.

"When will the government acknowledge its responsibility towards the sufferers and carers within the mental health community?"

A Department of Health spokeswoman said steps had been taken to strengthen primary care following recommendations made in the National Service Framework for Mental Health and the NHS Plan.

She said: "By the end of 2004, 1,000 graduate primary care mental health workers trained in brief therapy techniques will be employed to help GPs manage and treat common mental health problems in people of all ages.

"In addition, 500 more community mental health staff will be employed to respond to people who need immediate help.

"The National Institute for Mental Health in England is also establishing a primary care mental health programme to support the development of best practice."