MENTAL-HEALTH-CARE PRACTICES AND EDUCATIONAL-NEEDS OF GENERAL-PRACTITIONERS

Objectives: To describe current mental health care practices of general practitioners and to identify their educational priorities and training preferences. Method: Self-administered questionnaire to a stratified random sample of New South Wales general practitioners. Subjects: 721 full-time general practitioners, of whom 534 (74%) responded. Results: Mental health problems recognised by general practitioners at least once per week were psychosomatic (93%), emotional (89%), addiction (79%), social/economic (71%) and family (69%). At least two-thirds recognised sexual problems, sexual abuse and major psychiatric problems less frequently than once per week. Sixty-four per cent of general practitioners reported that patients felt uncomfortable about being referred to psychiatrists; 53% that referral service waiting lists were-too long; 51% that there were insufficient local mental health services; and 25% that communication difficulties between referring general practitioners and mental health specialists obstructed optimal care. Educational priorities were diagnostic and counselling skills, with particular emphasis on crisis, family, individual and marital counselling and strategies to prevent general practitioner burn-out. Conclusions: General practitioners are interested in improving their mental health counselling and diagnostic skills but barriers remain. Both structural and educational initiatives are essential to enhance the quality of mental health care in general practice.