| Project Objectives / Summary:
GPs within the Division had expressed a high need for support in dealing with psycho/social issues. To address this need, the Division developed a four-part program designed to improve the counselling skills and confidence of GPs and provide support and linkages for GPs performing mental health work in General Practice.
The project involved participating GPs taking up a four-tiered program of:
1) education and skills development training;
2) facilitated group support sessions for exploring cases and counsellors' personal and professional challenges;
3) individual professional supervision sessions (up to ten per GP); and
4) telephone support and case management.
Implementation of the first three tiers of the project was based on an action research methodology with participating GPs identifying their needs in the mental health area. GPs were given the opportunity to participate in a comprehensive ten-month program with three integrated components based around training, support and supervision. To maximise uptake, GPs were able to participate in any of the three components. The only prerequisite was that if they wished to join the Support Group, they had to attend most of the training sessions.
Implementation of the telephone support and case management service involved surveying all GPs in the Division to identify the areas they felt were a priority. Using this information, in addition to recommendations from staff contacts (CHDGP & GPDV) and consumer groups, seventeen panellists were recruited to provide telephone support.
Project Collaboration:
- Mental Health Staff at GPDV
- Various Psychiatrists
Project Outcomes:
Education, Support and Supervision
The post program evaluation indicated that the project was successful in achieving the pre-program aims identified by participating GPs of "increased skills and confidence, improved professional support and better time management". Whilst 100% of participating GPs felt they had improved their counselling skills overall, there were areas identified in the evaluation process where the project could have been improved.
Mental Health Management and Advice Telephone Service (MAATS)
Participation rates were much lower than anticipated. Usage rates of the service did not increase in response to the increased publicity drive and practice visit program conducted midway through the period the service was operating. GPs using the service all reported the experience as positive and, for these GPs, the project did meet its objective of providing telephone support and case management
However the Telephone Service did not meet the real needs of the majority of GPs within the Division for support in dealing with the psycho / social issues. Due to the constraints the MAATS service operated within, it was unable to be more than a "help" line and could not be a point of referral. A significant proportion of the GPs who contributed to the evaluation of the MAATS service stated that sub-acute situations were uncommon. The evaluation indicated more careful selection and promotion of panellists to overcome the "reluctance to contact strangers" barrier may have increased uptake. If this barrier is targeted through better selection of panellists, overall usage rates, given the number of reported sub-acute cases, are still likely to be low and may not justify the cost of implementing such a service. The findings from this project suggest that the support GPs need in the area of mental health is for education and training together with improved access to public psychiatric and counselling services for acute cases.
Recommendations:
- Ensure training and support sessions are well structured with firm guidelines.
- Start with the more popular and confidence building topics first.
- Consider including as a trainer/facilitator a GP Counsellor or Psychiatrist with experience in counselling in General Practice.
- Keep the time between sessions short, (no more than four weeks).
- Provide home-study reading material between sessions.
- To involve a wider range of GPs, repeat the training/support sessions at different venues throughout the Division, (the increased cost of this could be offset by holding less but more concentrated and structured sessions in combination with home-study material).
Disseminating Project Information:
- Divisional newsletters
- Project specific materials
Lessons / Assessment:
Evaluation of the service did not identify major deficiencies in publicity, promotion, and quality of panellists or ease of access. Major barriers affecting usage were the lack of real and / or perceived need together with reluctance to contact strangers. It is significant that GPs who did use the telephone service did not find the concept of contacting a stranger for advice difficult.
A deficiency in the project was the number of participating GPs overall. The Division was disappointed by this but made every effort to engage them throughout the duration of the project. The project was well conducted despite the extra energy that was needed to recruit and retain GPs.
The Division?s experiences as part of this project are transferable and could well be linked to other work being undertaken as part of the broader Mental Health Initiative.
Although this project is no longer formally operating, a significant result is the informal network developed among GPs and specialists. The processes employed and results of this project has assisted / complemented the work being undertaken by the Division.
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