Call for more support for GPs to address mental health crisis

The RACGP is calling for greater government support to enhance the role GPs can play in addressing mental health issues across Australia, particularly in rural areas.
 
It comes as waiting lists for mental health care grow around the country, with some patients being told they may need up to a year for psychologist or psychiatry appointments.
 
Among the proposed measures, the college is advocating for new Medicare items to allow longer GP consultations, and for long telehealth phone appointments to be made a permanent feature of the healthcare system.
 
The college is also pushing for a new incentive payment to help GPs identify and manage patients who require mental health services.
 
With recent floods, bushfires and a global pandemic affecting residents across the country, many general practices are reporting a vastly increased number of presentations for mental health issues.

GP and Chair of RACGP Specific Interests Psychological Medicine Dr Cathy Andronis said that COVID-19 has exacerbated a problem that was already deteriorating.
 
‘The issue in mental health is huge at the moment,’ Dr Andronis told newsGP.
 
‘It has been steadily rising for the last 10–20 years, it’s gradually got worse as life has got busier and more stressful.
 
‘The pandemic has been quite a blow on top of that.’
 
Aside from general practice experiences, recent surveys involving Australia’s psychologists also indicate that rising demand for mental health services has not been met by a sufficient increase in the capacity to address patients’ needs.
 
The Australian Psychological Society (APS) reports that a third of psychologists in the country are now unable to take any further patients on to their books.
 
A recent survey carried out among 1456 of APS members found that 88% of psychologists are reporting increased demand since the pandemic began.
 
Before COVID-19 had begun to spread, only 1% of psychologists were not taking on new clients. The current figure also marks a substantial increase since last July, when one in five psychologists reported they were not signing up new patients.
 
With the serious shortages in psychologists and psychiatrists, Dr Andronis believes more GPs need to develop advanced skills in mental health care.
 
‘I think it’s essential when two out of three of our consultations feature mental health as either a main or significant factor in the presentation,’ she said
 
‘In the long run, it’s much more efficient for the whole health system if we’re better trained at doing what people need at the moment.’
 
The college is encouraging GPs to train and deliver Focussed Psychological Strategies (FPS), and is advocating for the development of GP psychiatry pathways similar to those used for GP obstetrics and GP anaesthetics.
 
RACGP President Dr Karen Price said this would make ‘a real difference’, particularly in rural and remote Australia.
 
Describing the current situation as ‘a national emergency’, Dr Price said the issue is often at its most acute in more isolated regions.
 
‘If you live in a rural or remote area the options are especially scarce and that really worries me,’ she said.
 
‘GPs see the consequences of people who aren’t accessing the help they need for mental health issues almost every day.’
 
Dr Price said making longer telehealth phone consultations permanent would assist areas where help is hardest to find.
 
‘This is particularly important for patients living in rural and remote areas, where access to local GPs can prove challenging,’ she said.
 
‘If you need to drive a considerable distance to physically sit face-to-face with your GP, telehealth can make your life that much easier.’
 
Dr Andronis believes new Medicare items for longer consultations would be one of the most effective ways of supporting GPs.

‘[By] being encouraged through the Medicare system to do short consultations, we’re really walking in opposite directions,’ she said. ‘We’re walking away from the need. The need is for more time.’
 
Dr Price also highlighted the situation for many young people, pointing to the ongoing mental health impact of extended lockdowns.
 
As well as calling for better access to paediatricians, she said more psychologists, psychiatrists and mental health professionals such as occupational therapists are needed.
 
‘We need to ensure Australia has the right mental health support structures in place so that people can get the help they need regardless of where they live,’ she said.
 
‘The reality is that general practice is the most accessible service for many people who require mental health care. In some areas outside of major cities, GPs are the only option.
 
‘So, by investing in general practice we can help people who otherwise may fall through the cracks in the system.’
 
Dr Andronis believes that additional support for GPs to tackle an issue where some have felt helpless will have important psychological benefits for the profession.
 
‘Any injection of funds and support for GPs to do the work that they’re seeing most often more efficiently is going to lead to great dividends for everybody, for GPs’ mental health as well,’ she said.

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