Most of today’s general practitioners were originally taught about psychological medicine within the context of psychiatry, rather than general practice. The Royal Australian College of General Practitioners has only recently acknowledged GPs who practise psychological medicine as a specific interest group with specific training needs. In addition, an evidence based approach to mental health care in general practice is a relatively recent phenomenon. While we expect new entrants into general practice to have the advantage of more appropriate training in the future, established practitioners can choose to regularly review their practice in the light of the available evidence concerning what works in mental health care in general practice. Patients are aware that a GP psychotherapist is somewhat different from a psychologist or ‘counsellor’. S/he can prescribe medication, for example and has a deeper understanding of the relationship between physical health conditions and emotional wellbeing. But with this status come some significant responsibilities.
Should we be using different criteria by which to measure the appropriateness of treatment when such a broad array of therapies is promoted and so many options are available? What sort of evidence counts and where can we find it? This presentation considers some of these questions as philosophical and ethical issues around mental health care in general practice, especially with regard to the position that members of the Australian College of Psychological Medicine might wish the College to take.