Challenges GPs face re work-related mental health conditions
Innovative approach to developing user-centred clinical practice guidelines for GPs to assist with the diagnosis and management of work-related mental health conditions.
Each year in Australia, around 7820 workers receive compensation for work-related mental health conditions. For most of these workers, their journey through the system, and to recovery, begins with their general practitioner (GPs). Many GPs consider mental health claims to be difficult to diagnose and manage due to clinical and system complexities. To address this issue, the Department of General Practice is developing national clinical practice guidelines for GPs to assist with diagnosing and managing work-related mental health conditions. This work is being funded by the Department of Employment, Comcare, Queensland Treasury, State insurance Regulatory Authority, ReturnToWorkSA, WorkCover WA, and is supported by the Institute for Safety, Compensation and Recovery Research (ISCRR).
The first step in this project was to define the scope of the clinical guidelines by understanding the clinical needs of practicing GPs. A series of semi-structured interviews were undertaken with GPs, compensation scheme workers and psychiatrists across Australia to determine the challenges faced by GPs when treating patients with work-related mental health conditions. Prior to each interview participants reflected on two case-vignettes, each depicting a patient’s illness trajectory over 12 months and, in the interview, provided their perspective about the clinical challenges faced by a GP when treating these virtual patients.
A number of challenges were identified in relation to clinical aspects of care or dealing with a mental health condition within a compensation system.
Key clinical challenges included:
- A lack of confidence in accurately diagnosing a mental health condition
- Difficulty in determining the severity and work-relatedness of a mental health condition, and the implications of labelling a patient as having a mental health condition. Difficulty addressing patient attitudes and beliefs concerning return-to-work
- Uncertainty about the repercussions of managing mental health conditions through a claims process.
Key compensation system challenges included:
- Ambiguity between the roles of a GP, other health professionals and the compensation scheme
- Difficulties navigating compensation systems.
The challenges uncovered in this study are being used as the foundation to formulate the key clinical questions that will be addressed in the clinical guideline.
For more information about the work-related mental health guidelines project or to learn about our work in compensable injury, please visit our website: https://www.monash.edu/medicine/spahc/general-practice/compensable-injury