Time to recognise GPs’ mental health contributions: RACGP President

Nicole Higgins

10/10/2023 4:16:28 PM

New stats confirm general practice remains the cornerstone of Australia’s mental healthcare system, despite its role being taken for granted.

Female doctor consulting with a patient.
More than 35% of people with a 12-month mental disorder see a GP for their mental health every year, according to new Australian Bureau of Statistics data.

Australian GPs conduct more mental health consultations per year than any other specialty or clinician.
From 2020–22, 1.9 million people aged 16–85 sought treatment for a 12-month mental disorder, according to the Australian Bureau of Statistics (ABS).
Of those, more than one in three (35.5%) reported seeking help from a GP.
That’s at least 660,000 different Australians who relied on their GPs for support (the true number is almost certainly higher) in those three years, but somehow, we’re often overlooked in this space.
Whether it’s not being consulted on proposed systemic reforms, or missing out on much needed funding, general practice’s contribution to mental health care is taken for granted.
That needs to stop.
Because as GPs, we know that today – World Mental Health Day – we’ll be the ones answering the late-night phone calls and triaging patients.

We’ll be the ones spending countless hours working through a list of rejected psychiatrist referrals letters for those in most need of special assistance.

We’ll be the ones most impacted by seeing someone who grew up before our eyes break down in our consulting room as a nationwide mental health crisis continues to take its toll.
And in the rural and regional areas, like my home of Mackay, it’s even tougher. These places typically have some of the poorest levels of mental health services and access to mental health in the nation, despite a greater need.
We struggle to have access to specialist mental health services and psychologists. Often, it is just us.
Given all that we do, how is it that we’re overlooked?
Mainly, it’s because what GPs do is often unseen. We keep people out of more expensive services, and provide the all-important continuity of care.
But while most of us get on with the job with a minimum of fuss, the status quo cannot be allowed to continue.
For the sixth consecutive year GPs in 2022 reported that psychological issues were the most common health presentation that we faced.
In fact, almost 40% of general practice consultations in a typical week include some mental health component.
Unfortunately for GPs, that means we’re probably being underpaid for 40% of our consultations. Why? Because for some reason, Medicare rebates are lower for mental health item numbers than other ailments.
That is why today, we want to look forward to a future where GPs are given the investment needed to rollout adequate, meaningful, and compassionate care to all.
Where GPs are involved in mental health policy development and given a voice commensurate to the contributions we make.
We are the ones at the coalface delivering care and supporting people and their families through their mental health journey, and have firsthand knowledge of what is needed, and what needs changing.
Governments at all levels need to work together to help us, help our patients.
Mental health is complex and can often be confusing for our patients, which means a shorter consultation time is simply not enough to offer the evaluation needed.
Increased funding for longer consultations is crucial to ensuring every patient gets the care they need and deserve.
GPs have a wealth of knowledge and experience, and we want to help Australia address its mental health crisis.
We want to create a country that offers world-class care, no matter your postcode and where you call home.

But we can’t do it with one hand tied behind our back, and we certainly can’t do it alone.
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Dr Jane Elizabeth Christiansen   11/10/2023 11:52:01 PM

Item numbers do not reflect the mental health consultations carried out by GPs . Patients frequently and understandably present with a combination of physical and mental health symptoms / diagnoses . But because of evidence that GPs have been sanctioned for double billing ( for both mental health & physical health item numbers in one consultation ) GPs tend to bill for only one complaint usually a physical complaint ( ie item number 23 ) rather than adding a billing for mental health complaint. I suspect more prevalent for those GPs who take a holistic approach to General Practice care.

paused GP   8/11/2023 10:28:59 AM

Surely getting this issue of GP mental health rebates addressed well and truly, once and for all, by the AMA /RACGP and the Government is of the utmost importance. This needs sorting before we naively and blindly plough headlong into commitments to the newly diagnosed ADHD `crisis`. Did all the RACGP electorate vote on committing to this issue, which was not of our making?

Dr Daniel Bergman   20/11/2023 1:06:55 AM

Why is a rebate for item 2713 (mental health consultation greater than 20 mins) lower than an item 36 -general consultation more than 20 mins?
Most people I see for mental health need to be bulked billed. This is becoming financially impossible for me to do mental health. No psychiatrists / hospitals/ psychologists will help these people.
Seeing people break down/psychotic/suicidal sitting in front of me (usually with physical problems to), puts pressure on my moral compass and my financial situation.
It is becoming impossible.