Mental health workshop Medical Forum popped in on the ACRRM Mental Health Core Skills Training session. This was a conference version of the mental health training offered online. Completion of either gives doctors enough grounding to access Medicare Item 2715 to develop a Mental Health Treatment Plan in consultation with a patient. This training package was developed by Prof Geoff Riley, Dr Louise Stone and Dr Mike Eaton especially for rural GPs. Ben Tan said he found the course helpful, if only to confirm what he was doing with item numbers. Dr Russell Young from Albany learnt the importance of a good assessment of patients and the framework around Medicare item numbers. “Finding item numbers and what is going
Q Course developers Drs Mike Eaton (Busselton WA), Geoff Riley (Albany WA) and Louise Stone (Sydney).
to give you the best result for the patient can be very confusing. I spend a lot of time doing that. I work in ED so I do see patients with psychotic episodes in the middle of the night and in Albany we are well serviced with psychiatrists.” He said the ‘goldfish bowl’ effect of living in Albany was not bad compared to smaller towns but his wife, also a GP, has had some uncomfortable moments with mental health patients contacting her using social media. O
Q Drs Margaret Trudgen (Perth-Pilbara), Mike Eaton (Busselton WA) and John Parry (Qld) get involved in group discussion. Margaret learnt that most GPs are in the same boat – things are complicated in mental health and the hardest part is finding time. She said she had been navigating the item numbers since they first came out and she tends to use the treatment plan item number and forget about the rest.
Q Drs Richard Hayter (Qld), Russell Young (Albany WA), John Cooper (Thursday Island, ex Albany WA) and Ben Lee Tan (Lancelin, WA).
Q Drs Bill Gunn (Qld) and Sarah Moore (Busselton WA).
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Course background
Q Dr Louise Stone said getting the best treatment costeffectively for patients is at the absolute core of what doctors do. GPs learn which item numbers to bulk bill to assist patients who cannot afford to pay.
“Good rural and remote doctors are also very strategic in the way they set things up – the practice nurse doing something, getting the psychologist to do a group session, talking to the schools so they can introduce things –investing time in group things,” she said. Being well known in a small town has its difficulties.
“Relationships are important. Your next door neighbour is hitting his wife and she comes to you for help – it’s tangled so you have to pick what you can do in the therapeutic relationship, say when your kids go to school together. It’s tough, especially when you have to schedule patients.” “Every time I run a mental health session, whether online or face-to-face, there is some rural or remote doctor in the audience who has had a horrible trauma they haven’t been able to fix, or faced a suicide of someone close they think they should have picked. It’s a good thing to get doctors together so those stories get told.” “Geoff Riley tells us sometimes things are not preventable, even with the best will in the world – we don’t pick up heart disease, diabetes or depression sometimes and we have to live with that. You do your best and it’s about the realness of it – a complex business with no perfect solution. Honesty is very important.” “Geoff gets it because he has been rural and a psychiatrist. Mike Eaton and I are both on the mental health services collaboration. Mike is very real and very practical. He has a gentleness and speaks of his patients with great respect, which is really important.” O
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