Integration of General Practitioners and Mental Health Services: The Northern Queensland Integrated Mental Health Program

Abstract

The Integrated Mental Health Program is a joint initiative of the Northern Queensland Rural Division of General Practice, Townsville Division of General Practice, and the Townsville District Integrated Mental Health Service (IMHS).The program seeks to empower general practitioners (GPs) to meet current gaps in mental health service delivery in North Queensland, and establish better liaison and integration of services provided by GPs and by hospital and community based mental health professionals. Sixty-three GPs and twenty-four mental health professionals were interviewed across the two divisions to identify barriers encountered in the management of people with mental health problems. The barriers identified fell into three broad categories: those related to referral, to discharge, and to communication. A two-week audit of the IMHS intake and discharge processes provided further data to clarify the difficulties involved in the integrated management of patients with mental health problems. Two-week audits are to be conducted at six monthly intervals throughout the course of the program as a tool for evaluation of the program's effectiveness. General findings from the audit indicate that, although the levelof GP referrals judged by mental health professionals to be inappropriate is low, the lack of information GPs provide when referring may create ambiguity regarding the appropriateness of their referrals, thus creating the perception that they make inappropriate referrals at a higher rate than is in fact the case. Strategies for improving communication between GPs and existing mental health services are being explored, with early initiatives towards a system of shared care being developed.