Dr Grant Blashki

Dr Grant Blashki is a practising GP and Beyond Blue's lead Clinical Advisor

When you or one of your family members is experiencing a mental health issue, often the first point of call is the local general practitioner. There are good reasons why the local GP is a good place to start.

Firstly, often you and the family will have known the GP for some time, meaning you already have a trusted relationship. The GP should also have a good understanding of your background.

Secondly, the GP is well placed to undertake a holistic assessment looking at the mental and physical sides of your clinical presentation. For example, they might notice some physical illness or medication that is affecting your mental health. Or perhaps they may want to do a blood test or other investigations; this might be, for example, to detect a thyroid problem or a low blood count that could be contributing to your symptoms.

GPs also have a broad perspective when it comes to the local mental health services on offer. They know which mental health professionals are available and can refer you to someone suited to you.

But before we idealise GPs too much, it is true that GPs are often too rushed. They can be overworked, juggling many responsibilities and sometimes a busy general practice is not an ideal environment to discuss an in-depth mental health concern.

Here are some tips when thinking about going to the GP regarding a mental health issue:

1. Try to find the right GP for you

Asking friends and colleagues about their experience of speaking to a GP is a great way to find out which GPs are interested in mental health issues. The so called ‘grapevine’ still works very well.

When you phone for an appointment, medical receptionists will often tell you which GPs are likely to be most helpful regarding your particular mental health concerns. For instance, some GPs are excellent at getting on well with adolescents, whilst others might be better at ageing issues for example.

It’s also worth trying to find a GP that understands your cultural background and if need be, speaks your language. In our multicultural society, having a GP that actually understands who you are, and your community can be really helpful when navigating a discussion about mental health issues.

2. Check the cost

It’s a good idea to find out how much the consultation is going to cost, because not all GPs bulk bill and there may well be a private fee beyond the Medicare rebate.

3. Book a double appointment

Mental health consultations can’t be rushed, especially if the GP undertakes what is called a GP mental health care plan. This involves a systematic assessment of your mental health issues which also entitles you to Medicare subsidised rebate to be referred for psychological care.

4. Write down notes in advance

Write down some notes in advance so that you can explain what has been happening to you or your family member and accurately explain what you’re concerned about. Otherwise it’s easy to forget things. It’s also good to take some notes during or just after the consultation, so you can recall what you talked about with the GP.

5. Be upfront

Many people with mental health issues are embarrassed about their symptoms and only raise them late in the consultation. Evidence tells us that GPs are less likely to engage in a mental health discussion when the issues are raised late in the consultation, so best to speak up and express your concerns about mental health issues from the get go.

6. Follow up

Expect to book a follow-up appointment, as usually mental health issues aren’t sorted out in one consultation. It will be important to follow up with the same GP so that you don’t have to re-tell your story and the GP can carefully monitor your progress over time.

7. Ask the GP about their interest or training in mental health

Be aware that some GPs have done additional mental health training. For example, some general practitioners have undertaken extra mental health skills training that has been accredited which qualifies them to provide more in-depth mental health advice.

8. Consider a second opinion if not progressing well

If you don’t feel that you get on well with the GP or that your concerns are not being addressed, be willing to get a second opinion from another GP to see if perhaps some alternative treatment plans should be considered. As professionals, GPs are generally relaxed about this and want their patients to have the best chance of recovery.

You can follow Dr Blashki on Twitter.

Related reading: Questions to ask your health professional

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