Psychological problems in New Zealand primary health care: a report on thepilot phase of the Mental Health and General Practice Investigation (MaGPIe)

Aim. To carry out a pilot study in two regions in order to investigate prev alence of psychological problems in primary care in New Zealand. Method. General Practitioners (GPs) within two geographic regions were rand omly selected. All adult attenders at their practice on selected days were administered a short questionnaire, the GHQ-12, which assesses the presence of psychological symptoms. The GP recorded the reasons for each consultati on, and was interviewed at the end of each day about selected patients, to determine their opinion about the type of psychological problems experience d. Results. Three-quarters of selected GPs (76%) agreed to participate. 96% of patients attending their GP agreed to complete the GHQ. Scores from 385 co mpleted GHQ Screening questionnaires suggested that 23.4% of GP patients ha d significant psychological symptoms. When GPs were asked about the main re ason for consultation, they identified only 5.7% of current consultations a s being for psychological reasons. In contrast, the GPs thought that 20.6% of patients described having some symptoms which were either mildly, modera tely or completely psychological in the current consultation, and recognise d that 17.4% of their patients had a mild, moderate or severe case of psych ological disorder over the past twelve months. Conclusion. GPs identified one in five of their patients as having symptoms which were mildly, moderately or completely psychological, although psycho logical factors were the main reason for consultation in only one patient i n twenty. Previous reports of very low rates of psychological problems amon g GP attenders in New Zealand have been thought to indicate major differenc es in access to health care or prevalence of common mental disorders within primary care services in this country. However, the apparently low rates o f conspicuous mental disorder in New Zealand general practices may be bette r explained as an artifact of the type of questions asked.