MENTAL-HEALTH-CARE PRACTICES AND EDUCATIONAL-NEEDS OF GENERAL-PRACTITIONERS

Objectives: To describe current mental health care practices of genera l practitioners and to identify their educational priorities and train ing preferences.Method: Self-administered questionnaire to a stratifie d random sample of New South Wales general practitioners. Subjects: 72 1 full-time general practitioners, of whom 534 (74%) responded. Result s: Mental health problems recognised by general practitioners at least once per week were psychosomatic (93%), emotional (89%), addiction (7 9%), social/economic (71%) and family (69%). At least two-thirds recog nised sexual problems, sexual abuse and major psychiatric problems les s frequently than once per week. Sixty-four per cent of general practi tioners reported that patients felt uncomfortable about being referred to psychiatrists; 53% that referral service waiting lists were-too lo ng; 51% that there were insufficient local mental health services; and 25% that communication difficulties between referring general practit ioners and mental health specialists obstructed optimal care. Educatio nal priorities were diagnostic and counselling skills, with particular emphasis on crisis, family, individual and marital counselling and st rategies to prevent general practitioner burn-out. Conclusions: Genera l practitioners are interested in improving their mental health counse lling and diagnostic skills but barriers remain. Both structural and e ducational initiatives are essential to enhance the quality of mental health care in general practice.