Australian GP experiences and perspectives of mental health care for adolescents: a qualitative study

General practitioners (GPs) play a crucial role in providing timely and appropriate adolescent mental health care in Australia, and this involves working within the Medicare Benefits Schedule (MBS), the national framework that sets rebates and rules for subsidised medical services. This study aimed to explore the experiences and perspectives of Australian GPs in delivering care for adolescents experiencing anxiety and depression in general practice, with a particular focus on how GPs navigate the MBS in this context.

Fourteen GPs from Victoria, Australia, with experience in treating adolescents with mental health conditions took part in one-to-one, semi-structured interviews incorporating vignette-based discussions. Approaches to adolescent mental health care, perspectives on MBS mental health items and strategies GPs used to address challenges in care delivery were discussed. All interviews were recorded, transcribed and thematically analysed.

Four key themes emerged: (1) establishing a therapeutic alliance, (2) the assessment process, (3) treatment approaches, and (4) MBS descriptor complexities, which intersected with all stages of care. Although MBS descriptors were generally seen as easy to follow, GPs reported that they often conflicted with patient-centred care. Participants highlighted challenges in referral pathways and waitlist management, and emphasised the importance of holistic, biopsychosocial approaches. GPs frequently adapted the MBS frameworks to meet individual patient needs.

The study identifies a complex challenge for GPs, stemming from a misalignment between MBS descriptor requirements and their preferred practice of delivering patient-centred care. These findings suggest a need for MBS reforms to better support GPs in providing holistic, integrated care, with strengthened referral networks and multidisciplinary care models to improve adolescent mental health outcomes.