ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 273
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Community-based GP and psychiatry shared care for
complex mental health and chronic suicidality: The Your
Healthy Minds experience
Dr Daniel Henderson
Albany Hills Radius Medical Centre
Even before the pandemic, the burden of chronic mental health conditions was rising in Australia
and mental health care systems were becoming increasingly overwhelmed. Psychological problems
have now become the most common reason for presentation to a general practitioner (GP). GPs are
the largest craft group of doctors in Australia and are often the ‘heath worker of last resort’, left to
contain and monitor patients with treatment-resistant illness, complex PTSD and chronic suicidality
who are unable to afford or access community psychological or psychiatric care. These patients are
often deemed not acute enough for mental health unit admission or publicly funded services. These
complex ‘heart sink patients’ often exacerbate GPs’ burnout and now the pressures of the pandemic
has escalated all of these dynamics.
This presentation outlines a new and innovative model of care, a GP/psychiatry community
consultation/liaison shared care clinic. Where joint consulting strategies train GPs in and disseminate
innovative models of psychotherapy focused on self care and self regulation and monitoring novel
treatments such as oral ketamine that are normally managed exclusively by psychiatrists. The clinic has
so far treated over 800 patients with severe or treatment-resistant, complex mental health problems
and has published research showing a reduction in mental health hospital admissions of 60% and
reduced days admitted by 70%.
This model would be translatable to most primary care settings, which is often the first and sometimes
only point where many of these patients access their care and it integrates well with patients’ current
treatments. The psychotherapy approaches also assist GPs to self-regulate their intensity in consults
and manage the cognitive and emotional load of caring for these complex patients, therefore reducing
GP burnout and preserving our capacity to provide care in the face of such unprecedented demand.
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