Challenges facing primary care mental health in Australia

Changes to the organisation of mental health services in Australia and a recognition that general practitioners deliver the great bulk of mental health services to the community have necessitated a re-examination of the role of general practitioners in the clinical area.

This article examines controversies in mental health care such as the difficulties with detection, the nature of general practice psychiatry, the inappropriateness of undergraduate training, workforce related issues, mental health services in rural areas and continuing medical education.

General practice based services for people with mental disorders are distinct in many respects from specialist psychiatric services. Systemic changes need to be made to training for general practitioners, to incentives for delivery of complex care and to the way in which the different health care sectors work together.