Resources to assist GPs in ongoing mental health care

Morgan Liotta

27/10/2020 4:09:19 PM

Updated treatment plan templates are part of a nationwide effort to support GPs’ management of an upward trend in mental health presentations.

Illustration of brain
The updated templates include assessment for trauma-informed care and recovery-oriented approaches.

Mental health issues relating to the COVID-19 pandemic and the predicted long-term ripple now come as no surprise to most GPs.
Recent Medicare data show a 15% increase in Medicare-subsidised mental health services since March 2020, with 7.4 million services provided.
In Victoria – where the strictest lockdown has been ­– those figures were highest, with the number of subsidised mental health items increasing by 31% between September and October, compared to the same period last year.
Pandemic and natural disasters aside, reports from the past three years show that mental health presentations remain the number one reason people visit their GP, and these rates show little sign of slowing.
To assist GPs who are seeing an increase in mental health presentations, the RACGP’s General Practice Mental Health Standards Collaboration (GPMHSC) has released updated versions of its GP Mental Health Treatment Plans (MHTPs) templates.
Based on the most up-to-date evidence for best practice mental health assessment and treatment in general practice, the GP MHTP templates support GPs in the management of common mental health presentations under the Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative.
GPMHSC Chair Associate Professor Morton Rawlin said the templates will improve the quality of mental health care provision for patients by covering the many areas of psychological impact.
‘We have included assessment for trauma-informed care and practice [in the updated templates]. This will make a real difference for patients who experience traumatic events, including bushfires, floods and other natural disasters,’ he said.
‘The other key update is the inclusion of the recovery-oriented approach, which is designed to help define a patient’s personal goals and enable them to take steps towards their personal recovery.
‘This approach has been shown to make a real difference for patients, giving them the knowledge to direct their own changes to live a fulfilling and meaningful life – with or without the presence of mental health issues.’
In the wake of the 2020–21 Federal Budget, the RACGP called on the Government to better support general practice to successfully manage crises, such as the long-term health impacts of the pandemic and summer bushfires.
As part of the 2020­–21 budget’s mental health package, patients with an existing GP MHTP will have access to an additional 10 Medicare-subsidised psychological therapy sessions each year.
But, the RACGP believes that ‘appropriate safeguards and measures are needed’ to prevent any unintended negative consequences when increasing the number of Medicare Benefits Schedule (MBS)-related psychological therapy sessions. 
Although the college welcomed the extension of Medicare-subsidised telehealth, it is advocating for significant GP involvement in a long-term plan, including investing in new Medicare subsidies for longer consultations so GPs can spend more time with their patients experiencing mental health issues.
RACGP Acting President Associate Professor Ayman Shenouda said it is vital general practice receives the backing to manage the wave of mental health concerns.
‘The COVID-19 pandemic is having a huge impact on the mental health of patients across Australia, particularly in hard-hit areas like Victoria,’ he said.
‘As the first port of call for these patients, it is essential that the Government invests adequate resources in primary care so we can provide timely and appropriate mental health support.
‘Patients are often more comfortable discussing mental health with their GP with whom they have an ongoing and trusted relationship, they don’t have to approach a new face.’
As a rural GP, Associate Professor Shenouda also highlighted the importance of accessing mental health care for patients in rural and remote areas, who for some, ‘have nowhere else to go but their local GP’.
‘When it comes to addressing the problem of rising mental health concerns, investing in general practice and GPs to help patients is [obvious],’ he said.
The updated GP MHTP templates are available on the GPMHSC website.
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Dr Antje Vogelsang - Sharman   28/10/2020 7:32:02 AM

just looked at the template for adults - 21 pages ????????????? This is a psychological fist session assessment plan . WHO came up with this for a GP consult ???? there is no question about the increased need for mental health support - but this plan makes ME needing mental health support. be realistic about time constraints please.

Dr Janice Faye Sheringham   28/10/2020 3:42:34 PM

Complex it may appear, and yes, it may take longer to complete, but that time may just alter the item number to one with a higher rebate? Perhaps even contemplate asking the patient to prepare their thoughts as far as they are able to help fashion their plan before you make a joint approach? Nothing says it must be done at one sitting, and IMHO there are benefits of a therapeutic nature to tailoring the plan with as much patient input as practical over 2 consults. Thoughts?