Dr Grant Blashki – Tips for talking to your GP about anxiety and depression

In terms of what people can expect when
they go to GPs, I’d like to suggest a few tips. I don’t know, I just haven’t been feeling
right lately. The first is, pick the right GP. And
I guess in an ideal world we would hope that every doctor is absolutely fantastic at managing
mental health problems. But if you speak to people who’ve been through these problems,
common sense will tell you there’s going to be a variety of interest and skills in mental
health problems. Now your usual GP might be terrific, but otherwise maybe chat to friends
or family and usually the grapevine’s pretty good. People know which doctors are gonna
be pretty helpful. The second thing I’d like to say, is
GPs are very busy. Managing mental health problems is just one of the things we’re doing.
We’re managing diabetes and arranging immunisations and all sorts of other preventive care. So
it’s smart in my opinion to book a double appointment with the GP and try to pick a
time when they’re not gonna be absolutely flat out. So I can tell you Monday mornings
and often late on Friday are pretty busy times for most doctors. So if its possible to book
an appointment outside that time, that’s a good idea. Another tip for seeing the GP about
a mental health problem is to be upfront about the problem. A lot of people will come to
the doctor, and I’ll give you a brief anecdote here, a typical patient will come in, maybe
a guy and he’ll come in and he’ll say, “I’m just here for a check-up”. And you’re chatting
away trying to work out, you know your blood pressure’s fine, everything’s good and just
as he’s leaving he’ll turn the door, he’s got his hand on the door handle and he’ll
go, “Also I’m not sleeping too good, do you think there’s a problem there?” And we call
that “the door handle consultation”. Now of course you’ve got a full waiting room and
so the GP’s more likely to be a bit cursory or dismissive of that in the real world. And
in fact there’s research to show if you present your mental health problems late in the consultation,
the GP is a lot less likely to actually do anything about it, than if you’re upfront
about it. Another tip for going to the GP is to
write down what some of the problems have been. So, often people come to the GP and
they sort of freeze or they’re rushed or they make light of the problem. A classic example
would be some of the mums who are having postnatal depression problems. So they can present to
the doctor in a five or ten-minute consultation looking fantastic. Make-up’s on, everything’s
looking good and ask them how their going, “Fine”. So, sometimes if before you come to
the GP you write down some notes about what’s been going on. You might say, “Look, I haven’t
been sleeping” or, “You know, I’ve been having arguments”, or whatever the issues are, write
it down and that can be very helpful. If you’re really organised and you feel like going on
to the internet, the beyondblue website has some excellent resources and even some questionnaires
and you could take the time to fill one of those out. So a final thing to say about GPs, which
I think is very important, is we are the gatekeepers of the mental health system. What do I mean
by, ‘gatekeepers’? There’s a whole lot of mental health specialists out there. Psychologists
who’ve done a lot of training in counselling. Psychiatrists who are actually doctors who’ve
also done a mental health specialty, and your GP will know who all the local people are
in your area. In recent years the Commonwealth government
has set up a new program; what are called the Better Access and the Better Outcomes
in Mental Health Programs. There’s some very good information about these on the beyondblue
website. But fundamentally what they involve is making specialists more accessible and
affordable for the general public. So the process is you can go to your doctor and they
can undertake what’s called a Mental Health Plan, which is really a structured way of
them finding out what’s been going on for you, and arrange a referral to one of the
specialists, particularly psychologists, who are partially funded then through our Medicare
system. So it makes it a lot more affordable. And that’s a very good option for people to
be aware of.

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