Your GP and Mental Health Care
If you are worried about your mental health a GP should be able to help you. Some people may feel uncomfortable approaching the subject of mental illness even with a doctor, it may help to remember that your visit is private, confidential and the doctor will not be surprised by what you have to say. At least one in five people experience a mental disorder at some point in their lifetime. It may help to write a list of concerns and symptoms in advance and take it to the appointment. All doctors differ in expertise and experience in areas of illness and treatment. Some GP’s have received training in mental illness, and if your doctor hasn’t they can help by referring you to someone who has. They may find that a psychiatrist and/or a psychologist will be more suited to help you. As with every illness if you are not happy with any doctor a second opinion is always a good idea.
When should I see my GP?
Symptoms that may indicate a mental health problem:
- Crying uncontrollably on a regular basis
- Strong and continuous feelings of, sadness, anger, anxiety or panic
- Often feeling lethargic for no reason
- Excessive worrying
- Sleeping a lot during the day
- Problems sleeping at night
- Unusual weight loss or gain
- Deviant arguments with friends and relatives
- Total withdrawal from friends, colleagues and family
- Afraid to leave the home; refusing to go to school or work
- Significant changes in eating and/or sleeping patterns
- Extreme changes in mood – from excited to depressed
- Loss of mood variation – becoming flat and unemotional
- Deteriorating performance at work or school
- Feelings of unprovoked extreme anger
- Becoming overwhelmed with day to day stresses
- Cutting or hurting yourself
- Thoughts of suicide and feeling that life is not worth living
- Hearing voices or seeing things that no one else can hear or see
Certain behaviours can occur due to changes or stressful events in a person’s life. This may result in a person feeling over sensitive, over emotional, withdrawn or lethargic. This does not necessarily mean a mental illness is present, but speaking to a doctor may help to determine any other underlying causes of emotional changes.
Drugs, alcohol and excessive stress can make a person vulnerable to mental illness. Trauma, abuse and other difficult life experiences may contribute to, or trigger some forms of mental illness. Early intervention is vital in treating mental illness and GPs can offer valuable assistance in identifying any problems early on.
A GP can:
- Order tests to eliminate physical causes for symptoms
- Check medications you are currently taking for side effects
- Diagnose medically definable mental disorders
- Provide referrals to other mental health professionals, e.g. psychiatrists and psychologists, social workers and occupational therapists.
- Prescribe and monitor medication such as antidepressants
- Provide support
- Provide a personalised ‘GP Mental Health Care Plan’
What is a mental health care plan?
A ‘GP Mental Health Care Plan’ is a written document established by you and your doctor depending on your diagnosis and personal requirements. It will enable you to claim money from Medicare for professional services from psychologists and mental health workers. The form will take time to complete so it is best to book a double appointment with your doctor.
Medicare eligibility under a mental health plan
The GP Mental Health Care items are for patients with a mental disorder who would benefit from a structured approach to the management of their care needs. Mental disorder is a term used to describe a range of clinically diagnosable disorders that significantly interfere with an individual’s cognitive, emotional or social abilities.
This includes patients with the following mental disorders:
- Chronic psychotic disorders
- Acute psychotic disorders
- Schizophrenia
- Bipolar disorder
- Phobic disorders
- Generalised anxiety disorder
- Adjustment disorder
- Unexplained somatic complaints
- Depression
- Sexual disorders
- Conduct disorder
- Bereavement disorders
- Post Traumatic Stress Disorder
- Eating disorders
- Panic disorder
- Alcohol use disorders
- Drug use disorders
- Mixed anxiety and depression
- Dissociative (conversion) disorder
- Attention Deficit Disorders
- Obsessive Compulsive Disorder
- Other mental disorders that may require further treatment or assessment
This list of mental disorders is informed by the World Health Organisation, 1996, Diagnostic and Management Guidelines for Mental Disorders in Primary Care: ICD 10 Chapter V Primary Care Version.
Dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders for the purposes of the GP Mental Health Care items. (Better Access to Psychiatrists 1.8)
Preparing for your appointment
Before you see the GP to talk about your mental health concerns it is a good idea to prepare for your appointment.
What you can do:
- Write down any symptoms you have noticed, and when they started
- Write down any symptoms people close to you have noticed, and when they started
- Write down personal information that may be significant. For example: relationship problems, deaths of family and friends, traumatic events in your past or present and list the things that cause you stress,
- Make a list of other physical or mental health conditions you have or suspect you may have
- List the names and amounts of medications you are taking, including over the counter drugs and vitamins.
- Ask a friend or family member to go with you. With your permission they can report what they have noticed and this may help with your diagnosis.
Write down a list of questions to ask.
These may include:
- Do I need to see a psychiatrist?
- Do I need medication?
- How does this medication work?
- What are the side effects?
- How long will I have to take medication?
- How does a psychologist help with symptoms?
- Is there anything I should be doing to help myself?
- Even though you have a list of questions remember to ask the doctor to explain anything that you do not understand.
What to expect from your doctor
During your appointment, the doctor they will ask you a number of questions about your mood, thoughts and behaviour and possibly give you a questionnaire to fill out. You may be asked such questions as:
- How often do you feel sad?
- Have you had thoughts of suicide?
- What symptoms are you concerned about?
- How is your daily life affected by these symptoms?
- Have you been treated for mental illness in the past?
- What things make you feel worse?
- Do you hear voices that other people cannot hear?
- Have family members or friends commented on your mood or behaviour?
- Do you have any relatives with a mental illness?
- What medications or over-the-counter vitamins and supplements do you take?
- Do you drink alcohol or use illegal drugs?
Maintaining contact with your GP
If you have been diagnosed with a mental illness it is important to maintain regular visits with your doctor. If you don’t wish to remain with the same doctor for any reason be sure to have your records transferred to the GP that will be treating you. Even if you are seeing a psychologist and/ or a psychiatrist it is still important to maintain contact with a GP. If medication has been prescribed the doctor can ensure the dosage is correct and adjust it if necessary. Medication can cause unwanted side effects in some people and it is essential to tell your doctor if you notice anything unusual. Never stop taking your medication unless the doctor has advised you to do so. By suddenly ceasing medication that has been prescribed for mental illness the symptoms can actually become worse than they were before treatment.
Once you are feeling better let the GP know. You can discuss what has been helpful in your recovery and together learn to recognise early warning signs that may prevent a relapse in the future. If you move, request that your GP transfer your file to your new doctor.
“Data from the National Profile of Mental Health and Well-being study indicates that approximately 20% of the Australian population will meet the criteria for a mental health problem or disorder (ABS, 1997). Yet, only 38% of these people will seek professional help. Of those who do seek professional help, 75% do so from their GP.” (Primary Mental Health Care, AGPN)
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