Importance of GP continuity of care

The significant finding of the MaGPie Study into Mental Health supported GP continuity of care with patients, with GPs even more likely to identify mental health problems in patients they see more often.

Island Bay GP and College of GPs president Dr Helen Rodenburg was commenting on the report of mental health research done with GPs in the central region by Tony Dowell, John Bushnell and Debbie McLeod from the University of Otago’s Wellington School of Medicine. The first findings were presented at the Rotorua community mental health conference Building Bridges yesterday.

The findings challenge previously accepted views about low rates of identification by GPs.

“This is great,” said Dr Rodenburg. “It is research, New Zealand research, about what we do and it shows that GPs don't miss mental health problems as we have been told in the past.

“We want people to know GPs can help people with mental health problems.”

Dr Rodenburg said previously GPs had battled with the perception they did not pick up these problems, but that had likely been based on episodic research and specialist diagnoses.

The MaGPie study identified areas for improvement like drug and alcohol screening, especially in adolescents. The College will be announcing within a month a new alcohol screening initiative, she said.

In this first release, Professor Dowell said many people do not think anything can be done to help their mental health or emotional problems, and some do not identify their general practitioner as someone with the skills to help. Time pressure on GPs also affects what is talked about during a consultation.

The cost of GP consultations may also be a barrier to people seeking help for psychological problems.

The study achieved a very high response rate from GPs, 90 percent.

The study reported more than half of the people visiting selected general practices had experienced psychological symptoms, and one in three people had a diagnosable mental illness in the past year.

Dr Rodenburg said the very high 90 percent participation rate by GPS “shows our commitment to our patients.” It was the highest rate of response anywhere in the world for similar studies.

In the general population of New Zealand, as in other Western countries, over one quarter of the population have had a diagnosable mental disorder in the last six months. Three quarters of those with a recent mental disorder have attended a health (mainly general practice) service, but only about one third have sought specialist help.

GPs delivered three quarters of the treatment for mental disorders.

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