Western Australia's First and Regional General Practitioner Psychiatry Phone Line to Improve Primary Mental Health Care: Indicators of Effectiveness and Sustainability: A Non-Controlled Population-Based Interventional Study
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Published on: May 15, 2020
Hanh Ngo1, Michael Taran2, Beatriz Cuesta-Briand1
1The Rural Clinical School of Western Australia, School of Medicine, the University of Western Australia, Perth, Western Australia, Australia.
Objective(S):
To assess the impact of a regional General Practitioner Psychiatry Phone Line (GPPPL), embedded in a public Community Mental Health service (CMHS) on the wider health service's workflow and systemic outcomes.
Design:
Non-controlled population-based interventional study.
Setting:
Public CMHS in the Great Southern region of Western Australia (WA).
Participants:
Aggregated monthly data on (i) referrals to the CMHS (July 2017-March 2022), and (ii) Emergency Department presentations (July 2017-May 2022) were obtained from the West Australian Country Health Service.
Intervention:
Introduction of a regional GPPPL, for local publicly employed psychiatrists to provide specialist mental health care advice to General Practitioners working in the same region.
Main Outcome Measures:
Service input: Number of calls to the GPPPL, call duration and frequency. Service output: Rate of referrals to the CMHS, and rate of Emergency Department presentations related to mental health issues, and alcohol and other drugs.
Results:
The number of weekly calls to the GPPPL decreased (slope -0.13, 95% CI -0.17, -0.08; p < 0.0001) over the course of the one-year pilot. The referral rate to CMHS was approximately 70.5 referrals per 1000 person-years in July 2017, and quite steady pre-GPPPL (p = 0.9283), then reduced significantly post-GPPPL, by 1.7 (95% CI 0.14, 3.26; p = 0.0372) referrals per 1000 person-years each month.
Conclusions:
This study has demonstrated the GPPPL's effectiveness in reducing the referral rates to CMHS and its self-sustainability. The psychiatrists involved were able to continue full-time public service roles while running the phoneline, with a decreasing time demand over the one-year pilot.
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