GP the first point of call

GP the first point of call

Life & Style
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WHY you should see a GP if you are feeling down or anxious - and what to expect when you go.

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Chief executive of community health care body Western NSW Medicare Local, Dr Jenny Beange, says experiencing mental health issues is “common and normal” for anybody. Dr Beange, previously a general practitioner (GP), explains why you should see a GP if you are feeling down or anxious, what to expect when you pop in for a visit and what help your doctor will provide.

“EVERYBODY is likely to experience problems with mental health at some time in their lives.

If you do, you will be okay and you will get back to where you want to be.

It is about setting goals with someone, not about forcing anyone to do anything, see anyone or take anything that they don’t want to.

GPs have an important role to play in the mental health of a community.

You should see one when you feel your mental health is having an effect on your life or stopping you from participating in the things that you used to – essentially if you have a current and persistent level of sadness or anxiety.

Issues may demonstrate themself by generally feeling withdrawn, not wanting to go out with friends, not keeping in touch with people you normally would.

You may experience a lack of concentration at work, disrupted sleep patterns or overreacting to small incidents.

I would emphasise that non-medication options are the first thing we aim for with common presentations of what we call mild anxiety or depression, which are different ways of expressing the same illness.

Some people have anxiety, some have depression and most have a mix of both.

Your GP will discuss your general wellbeing – what’s going on in your life with family, work or school and ask things like “was there anything that might have predisposed you to feeling like this?”.

The doctor will want to know about any medications, alcohol or recreational drugs you may take.

They will also do a comprehensive interview about physical and mental wellbeing, including a physical check-up and questions about family history and predisposition to mental illness.

The GP would want to rule out physical causes for mental health issues you may be experiencing.

A range of physical issues can be contributing factors so the doctor may ask about fatigue, overexertion through exercise, thyroid problems and so on.

There is a depression screening tool, which is very quick and easy to use, where you rate one to five statements like “I have never felt so unhappy”.

It is a well-researched and evaluated tool which indicates if you have a certain score you are likely or not to have depression.

It is helpful to repeat the screening on follow-up visits to see if your mental health is improving or deteriorating

Your doctor will develop a mental health plan with you that outlines what you want to achieve and how you can achieve it.

The plan will use identified risk factors that can be addressed, which may include diet, alcohol usage, sleep patterns and in particular physical activity.

Your GP will discuss ways of approaching the problem and would encourage you to look at unhealthy behaviours and focus initially on improving your physical wellbeing and the non-medication solutions.

There is a strong correlation between physical activity and improving mood.

Often another step would be to talk about what events preceded your current issues and if it may be appropriate to see a psychologist for cognitive behavioural therapy, which can help you make different choices and get you into a more positive state of mind over a period of time.

The majority of mental health consultations with GPs are bulk billed because there is a higher fee attached.

It is up to you to find a GP you are comfortable with and to get engaged in getting better, but your doctor is there with the support you need and will stick with you until you do.

Don’t be embarrassed to talk about mental health.

You will feel better once you have and there are a lot of different avenues for support.

It doesn’t mean you are any different to the person next door.”

STEP ONE

Visit your GP who will assess whether you have a mental disorder and whether

the preparation of a GP Mental Health Treatment Plan is appropriate for you, given your health care needs and circumstances.

If you are diagnosed as having a mental disorder, your GP may either prepare a

GP Mental Health Treatment Plan, or refer you to a psychiatrist who may prepare a psychiatrist assessment and management plan.

STEP TWO

You can be referred for certain Medicare rebateable allied mental health services once you have:

  • a GP Mental Health Treatment Plan in place or
  • are being managed by a GP under a referred psychiatrist assessment and management plan or
  • been referred by a psychiatrist or paediatrician.

Your GP or psychiatrist/paediatrician can refer you for up to six individual or six group allied mental health services, which may include psychological assessment and therapy by a clinical psychologist or focused psychological strategies by an allied mental health professional.

STEP THREE

Depending on your health care needs, following the initial course of treatment (a maximum of six services but may be less depending on your clinical need), you can return to your GP or psychiatrist/paediatrician and obtain a new referral to obtain an additional four sessions to a maximum of 10 individual and 10 group services per calendar year.

This article was first published in The Land's 2013 Glove Box Guide to Mental Health. To read more from the guide, click here.

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