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General practice ‘not recognised’ in mental health agreement

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The RACGP has called for the Productivity Commission to better recognise the vital role general practice plays in mental health care provision, as the commission conducts its review of a new agreement between the federal, state and territory governments.
 
The National Mental Health and Suicide Prevention Agreement sets out the shared intention of each level of government to work in partnership ‘to improve the mental health of all Australians’, with a focus on priority groups.
 
In the college’s submission to the review, RACGP President Dr Michael Wright said while the college supports the Agreement’s overarching principles, its lack of recognition and support for general practice across several key areas is a concern.
 
‘General practice is central to the provision of mental health care,’ he wrote.
 
‘Most mental health care in Australia is provided in general practice, but general practice is not recognised in the Agreement.’
 
‘General practice is the most accessible service for those who require mental health care and, in rural areas, often the only service available.
 
‘This is particularly pertinent in the current climate where there are mental health professional workforce shortages.’
 
The Agreement’s core aims are to lower the suicide rate toward zero, and ensure the sustainability of an enhanced Australian mental health service and suicide prevention system.
 
It notes current and often cumulative challenges, with the need to improve the country’s public mental health system amplified by drought, bushfires and COVID-19.
 
The RACGP response recommends the Agreement includes:

• the central role of GPs in providing mental health care
• social prescribing as an additional tool to manage mental health, by addressing issues such as loneliness and social isolation
• recognition of the impact of social determinants of health
• appropriate integration and adequate investment in services that provide comprehensive mental and physical health care, to prevent care fragmentation.

Dr Wright points out that mental health issues frequently exist alongside other conditions, and people living with mental illness often have poorer physical health.
 
‘General practice encompasses both mental and physical health needs, with no distinction between mind and body,’ he said.
 
Dr Wright said the Agreement fails to give ‘any consideration’ to the impact of social determinants, such as low socioeconomic status, focusing instead on health interventions.
 
‘When addressing tangible issues like homelessness, unemployment, poverty or housing insecurity, the Agreement simply refers to linking individuals to pathways rather than committing either level of government to addressing the root causes of these socioeconomic determinants,’ he wrote.
 
‘People who have a lower socioeconomic status are at an increased risk of death by suicide and are more likely to avoid seeking care due to costs.’
 
To improve access to and affordability of mental health care from GPs, the RACGP has long called for a 40% increase to all Medicare rebates for level C and D consultations.
 
Dr Wright said this is a ‘simple and effective way’ to offer extra support to people with complex health needs.
 
Another RACGP recommendation, for a 25% increase to Medicare rebates for GP mental health items, will make it more viable for GPs to provide the extra time for these enhanced services to patients, Dr Wright said.
 
‘This increase would have a significant positive impact for the thousands of Australians struggling with mental health challenges,’ he said.
 
The Productivity Commission is due to release an Interim Report on the Agreement by June 2025.
 
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mental health productivity commission rebates social determinants suicide prevention

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