How to Tackle Mental Health?

An article discussing the problem was published in the current issue of the Medical Journal of Australia.

According to Professor of Psychiatry, Ian Hickie, one major cause of this gap is the current best practice guidelines are not relevant to the General Practitioners (GPs) they are designed to help.

Currently guidelines are developed by specialists from leading research and distributed to their target audience, GPs.

However Prof Hickie notes that a recurring question seems to be how relevant are these guidelines to the GPs themselves?

"Although guidelines are critical to improving health care quality, in the end most fail to recommend strategies that lead to real impacts on clinical practice," says Prof Hickie.

He says that from the perspective of GPs, most mental health guidelines don't consider the basic limitations of primary care, despite 75% of mental health consultations taking place in the primary care environment.

Prof Hickie suggests the most useful mental health guidelines should tackle those issues that occur on a daily basis:

• identification of less severe forms of a disorder,
• overlap with alcohol and substance misuse,
• use of alternate treatments for less severe cases, and
• the implications of poor or limited access to specialist assessment.

He lists such common questions as: where are the best resources for education and self-help? What options are available to a GP if patients become a danger to themselves? And most importantly, what should the GP do when specialist services are not available?

Part of the new funding and revision of mental health provisions in Australia should be attention to guidelines for GPs as a relevant and useful resource, says Prof Hickie.

"Insufficient attention to the practice-based issues risks an overall negative rating from the target audience."

The Medical Journal of Australia is a publication of the Australian Medical Association.