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Upskilling GPs to identify child mental health issues


Anastasia Tsirtsakis


2/11/2020 2:01:02 PM

A new RACGP-accredited online course is designed to enhance GPs’ clinical practice in supporting children and their families.

GP speaking with a child
GPs are in a key position to assess, manage and support children’s mental health.

One in seven.
 
That is the number of young people aged 4–17 who experience a mental health condition in any given year in Australia.
 
But 2020 has proven to be a year like no other, and experts fear the impacts on young people’s mental health.
 
‘There is a group of children who’ve been through a bushfire trauma and then went straight into a COVID pandemic,’ Dr Penny Burns, member of the RACGP Specific Interests Child and Young Person’s Health network, told newsGP.
 
‘That’s the group in particular that we need to be really aware of.’
 
While research has shown the majority of children do not receive any treatment for their mental health issues, those who do largely obtain that help from their GP.
 
‘GPs are in a really key position,’ Dr Burns said.
 
‘They see lots of children coming into the practice, not necessarily for mental health issues, for other issues. But then they have that opportunity to check how the child’s going, not only physically, but mentally.’
 
Even when the consultation is focused on the parent or guardian, Dr Burns says it is important GPs also keep the child in the room in mind.
 
‘When a patient comes in who, for example, is a mum who’s got a mental health issue, think about what you would call the “invisible child” that’s actually experiencing that mental health condition as well,’ she said.
 
‘Try and actively think about whether you need to be doing something for that child as well. It’s just a matter of asking the questions.
 
‘But if you ask the questions and you take the lid off, you start to find things. So you then want to be very clear about what you’re going to do about that.’
 
To enhance GPs’ skills and confidence, Emerging Minds has developed A GP framework for child mental health assessment (5–12 years), an RACGP-accredited e-learning course, for the National Workforce Centre for Child Mental Health.
 
Divided into four parts, it features interactive materials such as case studies, interviews with GPs, videos and animations that centre on assessing, managing, and supporting children and their families, including:

  • knowledge of common child mental health conditions
  • engagement skills for interacting with a child and their family
  • practical skills for child mental health assessment and management.
Dr Burns, who was involved in the course’s development, says the cases studies are scenarios commonly seen in general practice and give insight into different presentations of mental health issues.  
 
‘For example, a child visiting with abdominal pain and what’s really happening is that it’s an emotional behavioural presentation around grief at the loss of a grandfather. There’s another one about a teenage girl and bullying,’ she said.
 
‘Experts unpick what that presentation would then mean in general practice and how you would approach assessing that child, and then looking at how to manage them with a team approach.
 
‘Also how to engage the parents and child in undertaking an assessment of what the child needs and how best to move forward – that in itself is a difficult thing to do.
 
‘Sometimes children can be very, very difficult to engage, particularly adolescents. So it looks at common mental health difficulties in that age group and how to develop a comprehensive plan.’
 
The course is also accredited by the General Practice Mental Health Standards Collaboration (GPMHSC) as a stand-alone clinical enhancement module as part of the Mental Health Skills Training (MHST) modular pathway, and as a Professional Development Program-accredited activity with the Australian College of Rural and Remote Medicine (ACRRM).
 
Upon successful completion, GPs will have attained Level 1 MHST to do mental health care assessments and plans using Medicare item numbers 2715 and 2717.
 
With half of all mental health conditions starting by age 14 and 75% before 25, Dr Burns says GPs can play a significant role in early intervention.
 
‘Mental health disorder[s] are linked to a range of problems in adolescence and early adulthood, such as unemployment, poor educational outcomes, physical health, drug and alcohol use,’ she said.
 
‘So if we can address mental health conditions earlier on, we have an opportunity here to make a difference.’
 
A GP framework for child mental health assessment (5–12 years)  is an RACGP-accredited activity and will attract 40 CPD points. Estimated to take approximately six hours, participants can complete the course at their own pace.
 
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Dr Henry Arthur Berenson   3/11/2020 9:18:48 PM

The doctor/actor in this a credited activity orders a blood test on a child for no clinical reason and justifies it as a reason to recall the family - a " bridging" action to keep the family attending. Has anyone from the RACGP looked at this? There is no easier way to alienate a child and destroy rapport.