The impact of mental illness: A GP’s perspective

Mental illness affects the person’s family and friends and can often result in a person not being able to hold down employment. This therefore flows onto greater effects throughout society.

According to Dr Ryan Harvey at House Call Doctor, the collaboration amongst services, including GPs, counsellors and the hospital system, is vital in helping people with mental illnesses. Before becoming a qualified GP, there are many training courses that must be completed – including those related to mental illness, depression and suicide.

“GPs have undergone mental health training through University and post graduate training. This gives them the skills to make assessments and initiate treatments for people at risk of suicide,” Dr Harvey said.

If a person is at risk of suicide and there is insufficient community support to ensure the person’s safety, then a referral and transfer to hospital or mental health facility is required.

There are many resources available to GPs to aid them in managing suicidal patients, from The Royal Australian College of General Practitioners (RACGP) college guidelines to The Royal Australian and New Zealand College of Psychiatrists (RANZCP) college information.

GPs can also call and obtain advice over the phone by consulting with psychiatrists or other mental health services. Treating patients with mental health issues is a core function of general practice, as the majority of mental health issues are treated and managed by GPs.

According to Dr Harvey, when a patient is no longer safe due to high suicide risk, a referral and transfer to a hospital or mental health department is made. This is usually facilitated by calling an ambulance who will transfer the patient to the nominated hospital via the Emergency Department. From there, a physical assessment is made before admission to a mental health ward. It is standard practice to phone the admitting psychiatrist first before transferring the patient to hospital.

In the event where a patient may refuse to cooperate and continues to pose a risk to themselves, an emergency examination order can be enacted. In life-threatening circumstances, emergency services can also enact this order and then, against the patient’s wishes, transport them to hospital where a psychiatrist is required to make an assessment within 24 hours. A psychiatrist will then either determine the patient is no longer at risk to themselves and remove the order, or if the patient remains at risk, impose an involuntary treatment order.

“I have had experiences working as a GP and a hospital doctor where I have needed to impose these treatment orders, so patients would not harm themselves,” Dr Harvey said.

Suicide remains a major cause of mortality for the young and all efforts need to be made to adequately treat mental illness in our society.

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