GPs call for improved mental health funding

Larissa Dubecki

8/11/2017 4:33:35 PM

GPs need to be better remunerated for treating patients experiencing issues of mental health, prominent GP and former President of AMA Victoria Dr Mukesh Haikerwal told newsGP.

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‘Looking after someone with a mental illness is time-demanding. It does put GPs in a quandary because, to put it bluntly, it’s not a good business decision,’ he said. ‘Some GPs will avoid these cases and refer cases on to someone else, but many will do them because they care about their patients.’
The RACGP’s recent benchmark report, General practice: Health of the nation 2017, revealed that issues of mental health dominate GPs’ time in consultation. Issues such as depression, mood disorders and anxiety were cited as the most common basis for patient presentation in general practice.
Increasing rates of psychological presentation serve to highlight inequities of the Medicare system, which is geared against GPs who spend too much time on mental health consultations, according to Dr Haikerwal. He also said Medicare audits of practitioners who spend longer with patients with complex problems are a prevalent and often-corrosive part of many Australian GPs’ lives.
‘It really should be recognised that it takes longer to treat someone with a mental illness,’ he said. ‘We are getting much better as GPs and as a society at diagnosing and treating mental illness, but not in the way we reward those GPs.’
The level of time GPs spend on issues of mental health, combined with the anticipated increase of such presentations over coming years, has seen the profession highlight this area as one that requires an urgent government response.  
RACGP President Bastian Seidel told newsGP that the situation represents a clear warning of both the current frequency and future potential impact of psychological ailments on individuals, the community and the broader health sector.
‘The health and funding issues … must be crucially addressed,’ he said. ‘We have to be asking our patients, are you okay? And if we want a genuine dialogue and therapeutic conversations with our patients, we can’t do this in six minutes.
‘It has to be properly funded.’
Dr Seidel highlighted the complex interaction between mental health issues and extant medical conditions, such as obesity, heart disease and stroke, as another complicating factor in GPs’ treatment of such patients.
‘It requires time and trust to bring these issues out into the open,’ he said.

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Dr Henare Broughton   13/11/2017 5:02:45 PM

The emphasis for primary care is to have shift of thinking to more prevention of ill health to promoting health and be funded accordingly. In terms of funding primary care medicine it is public health and epidemiology that are the sources of potential funding more notably the environment, I would argue for a greater integration of primary care and public health and the impact that both could reduce cost secondary care but enhance primary and public health.
Mental health is influenced by environmental factors influenced by personal and social interactions.

Thelma   27/08/2018 2:42:50 PM

Surely mental health care should be referred accordingly - to a trained psychologist - which will free theGP's time and allow focus on primary health care. I can see how a GP can get caught up in a long discussion on mental health with any given patient, but that should be limited to one such session only and then referred to a specialist. Or GP's who are interested in mental health could gain the necessary qualification and charge accordingly.