03 July 2024

Supporting GPs to support patients with mental health issues

GPs are urging government to help them care for people experiencing mental health challenges.

It comes following the release of the College’s Guidelines for preventive activities in general practice (10th edition). Known as “the Red Book” and first published in 1989, it supports preventive activities in general practice. The 10th edition has a strong focus on mental health matters, including new entries on anxiety, eating disorders, perinatal mental health, and related issues such as gambling. It also features vital content on alcohol use, depression, smoking and nicotine vaping, and suicide.

RACGP President Dr Nicole Higgins, a Mackay-based GP with a special interest in adolescent mental health, welcomed the release of the guidelines and called for government to have the backs of GPs.

“GPs play a vital role helping patients experiencing a range of mental health challenges; however, with the right kind of changes, we could be doing even more,” she said.

“Psychological issues are the most common health issue managed by Australian GPs, making up nearly 40% of all patient consults. If you’re a GP in a rural or remote area, where access to psychiatrists and psychologists can prove challenging, you may well provide almost the entirety of mental health treatment for your patients.

“Medicare needs a makeover. It’s structured in a way that discourages longer consultations, and that must change. We know that mental health consults cannot be rushed, and that’s why we are continuing our calls for a 20% increase to patient rebates for longer consults and consults concerning mental health, with extra support for rural patients.

“Let’s not stop there. As things stand, patients only have a limited number of sessions under the Better Access Initiative to access consultations with a psychologist or a GP under the GP Focused Psychological Strategies items. By ‘decoupling’ the number of Medicare Benefits Schedule-supported sessions available for a patient to see a psychologist from the number of rebated sessions to see a GP under the Focused Psychological Strategies, we can boost mental healthcare options. It will also motivate more GPs to use these strategies in their practice.

“GPs must be included in mental health policy development and planning at all levels. We have the knowledge and experience to help Australia address its mental health crisis, and ensure no patients miss out on the care they need.”

Professor Danielle Mazza AM, Chair of the Red Book’s Executive Committee, said the 10th edition contained key guidance on when to be alert to possible mental health issues such as anxiety.

“Mental health can be a complex area and GPs do a tremendous job helping patients,” she said.

“This Red Book provides recommendations and guidance that can make all the difference. For example, we know that anxiety is the most common mental health condition experienced in Australia, and as the Red Book outlines, GPs should alert to possible anxiety disorders in those aged 8–64 years, including pregnant and postpartum women, particularly in people with a history of an anxiety disorder, possible somatic symptoms of an anxiety disorder, in those who have experienced traumatic or adverse childhood events, or in those with insomnia. We should also be aware of a patient’s worries about stigma and that under-reporting by patients is common.

“Perinatal mental health is one area where we have come such a long way, but there is still much room for improvement. This vital period covering the first year after birth is a time of huge change and a high-risk time for the onset and relapse of mental health conditions. It’s estimated that perinatal anxiety and depression affects one in five mothers. So, the Red Book features targeted guidance on screening, including for intimate partner violence, and assessing psychological risk factors as early as we can in pregnancy, and again after birth.

“My message to any patient experiencing mental health issues is to please reach out and book a consult with your GP. We are here to help, and taking that first help is so important, so please don’t delay.”

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