Management or missed opportunity? Mental health care planning in Australian general practice
Michelle Banfield
A C , Louise M. Farrer A and Christopher Harrison B
A Centre for Mental Health Research, 63 Eggleston Road, The Australian National University, Acton, ACT 2601, Australia.
B Menzies Centre for Health Policy, Charles Perkins Centre (D17), University of Sydney, NSW 2006, Australia.
C Corresponding author. Email: Michelle.Banfield@anu.edu.au
Australian Journal of Primary Health 25(4) 332-338 https://doi.org/10.1071/PY18150
Submitted: 11 September 2018 Accepted: 8 May 2019 Published: 22 August 2019
Journal Compilation © La Trobe University 2019 Open Access CC BY-NC-ND
Abstract
General practice care plans are designed to improve the management of chronic illness, facilitating multidisciplinary care and enabling GPs and consumers to work collaboratively. Evidence suggests that they work well for chronic physical illnesses, but it is unclear if they operate as intended for people with mental disorders. The aims of this study were to: (1) compare rates of creation and review of GP care plans for mental disorders and type II diabetes; and (2) examine consumer experiences. Secondary analysis of 109 589 recorded encounters from a national cross-sectional study in Australian general practice (2006–16) demonstrated that encounters involving creation of a care plan for depression or anxiety were significantly higher than those for diabetes, bipolar disorder and schizophrenia. Rates of review were commensurate with creation of plans for diabetes, but not for mental disorders. Eighteen people with a GP care plan completed an online survey about their experiences, reporting that care plans facilitated access to allied health professionals, but did not improve the quality of care they received. Findings suggest that care plans are underutilised for people with low prevalence mental disorders, and while they offer financial benefits to consumers, they may not result in ongoing, collaborative care.
Additional keywords: anxiety, bipolar disorder, depression, management plan, primary care, schizophrenia.
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