The need to upskill rural general practitioners in mental health care

Letters In Reply: There is no denying the key role played by general practitioners in treating and supporting people with mental illness. Australian and New Zealand College of Psychiatrists. © 2015 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. doi: 10.5694/mja15.00819  For the majority of people suffering a mental health condition, a GP is most well-placed to assist, with support from a psychiatrist if required. For a minority, a psychiatrist’s additional training in the biological, psychological and social factors that affect mental health will be essential. Every day, psychiatrists work closely with GPs, assisting those who are less confident, and consulting on complex cases. This is an appropriate use of specialists, especially in rural locations, and is unlikely to change. Psychiatrists have no need to “drive up” referrals. However, the Royal Australian and New Zealand College of Psychiatrists has identified that some in the community are confused about the role played by psychiatry. This is both a challenge for the profession and a problem for the health system. People over the age of 45 are more likely to present at a hospital and are considerably more likely to consult a GP than to ask for a psychiatric referral, even when dealing with suicidal thoughts. To acknowledge that this is a problem that increases pressure on primary care services is not to disparage the excellent work of GPs. An increased understanding of the different roles played by doctors working in mental health care will benefit all concerned. Similarly, greater training for some GPs would benefit both the medical and the broader community. When we are talking about the important matter of mental health and the best methods of ensuring that our patients receive the care they need, there can be no “turf war”. Malcolm J Hopwood FRANZCP, MPM, MD Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC. malcolm.hopwood@ranzcp.org Competing interests: I am President of the Royal MJA 203 (5) · 7 September 2015 211