The need for communities to access appropriate mental health care is consistently increasing the demand on General Practitioners who are already under-resourced to meet current health care expectations. The majority of people with a mental illness live and receive treatment in the community where General Practitioners are estimated to see 75 to 90 percent of patients with mental illness across the full range of illness severity (Keks et al 1997).
In recent years formal submissions to the Commonwealth Select Committee on Mental Health : Senate Inquiry (2005) into the effectiveness of mental health service provision, highlighted the inadequacy of the state funded public mental health system included in such titles as ‘Not a failure of Policy, it is a failure of implementation and delivery’ and ‘Not for Service; Experiences of Injustice and Despair in Mental Health Care in Australia’
In response the Commonwealth Government committed $1.9 billion to the “Better Access to Mental Health Care Initiative’, in recognition that 30% of patients in General Practice have a clear primary psychological disorder, and that General Practitioners are well placed to provide mental health care to the majority of those suffering from a mental disorder.
Australian Mental Health Services trains and provides specialized mental health nurses to support General Practitioners, offering a model of care that is a practical and accountable alternative and that may lead to significantly more efficient and effective health outcomes for persons with a mental illness and their families. This model also alleviates the patient loads of GPs, simplifies access to specialized mental health care, simplifies the effective implementation of this mental health strategy and optimizes the business of General Practice.
In the past decade mental health, and depression in particular, has received a great deal of attention both in the general and medical media. Awareness of depression has markedly increased, attempts have been made to reduce its stigma, and a lot of effort has gone into educating GPs. No-one would argue that this has not been a positive development. However it has lead on occasions to an oversimplification, where all bad moods are depression, and depression always responds to evidence based treatment with CBT & an SSRI.
To be human is to experience anxiety. As practitioners we encounter anxiety in many forms, including overt panic attacks and phobias as well as less distinct yet still pervasive everyday anxieties. From an existential perspective, anxiety is a universal phenomenon arising from our deep-seated responses to living in an uncertain world. Hence, anxiety is common to all humans and is something to be embraced rather than avoided.