Primary care experience of people with long-standing psychological problems: evidence from a national survey in England.

People with psychological problems face important challenges in obtaining high quality healthcare. We review evidence on the experience of primary care by people with mental health problems, including reasons why their care may be reported as worse than other groups. In the 2009 English GP Patient Survey, 5.7% of 2,163,456 respondents reported that they had a long-standing psychological or emotional condition. In an unadjusted regression model, respondents with long-standing emotional or psychological conditions rated their experiences worse than people without such problems, with scores which were up to 3 percentage points lower on individual survey items. However, after controlling for age, gender, ethnicity, deprivation and self-reported general health, people with long-standing psychological or emotional problems had slightly higher scores on 16 out of the 18 survey items, though with the equivalent of less than 2 percentage points difference for most items. Part of the reason for the difference between the adjusted and unadjusted models was the high prevalence of self-reported 'fair' or 'poor' general health among people who reported psychological problems. Overall, the results suggest that people with long-standing psychological and emotional conditions have similar experiences of English primary care compared to the rest of the population.