General practice encounters for psychological problems in rural, remote and metropolitan areas in Australia.
OBJECTIVE
Previous Australian research suggests there is very little difference in the prevalence of mental health disorders across rural, remote and metropolitan areas. However, mental health specialists are particularly scarce in rural and remote areas and some researchers have argued that non-metropolitan residents rely heavily on general practitioners (GPs) for mental health care. This article investigated rates of GP services for psychological problems across rural, remote and metropolitan areas.


METHODS
The Bettering the Evaluation and Care of Health (BEACH) program, Medicare and Pharmaceutical Benefits Scheme data were used in this report. Data included all psychological, depression and anxiety problems reported as managed by GPs and prescriptions for mental health medications (written and filled). Problem and medication rates are given per 100 patient encounters and per 1000 population.


RESULTS
Only a few regional differences were evident in the rate of psychological problems and prescriptions for mental health medications per 100 GP-patient encounters. However, rural and remote residents visited GPs less frequently than their metropolitan counterparts. Lower rates of GP encounters for psychological problems were evident for residents of most non-metropolitan areas (per 1000 population). Additionally, GPs prescribed mental health medications at half the rate for residents of remote areas than capital cities.


CONCLUSIONS
General practitioners provide fewer mental health services per capita in non-metropolitan areas. This difference could represent completely untreated psychological problems or fewer follow-up consultations. While non-metropolitan residents have limited access to specialists, rates of GP encounters for psychological problems are also very low.
Caldwell
T M
TM
Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia. Tanya.Caldwell@sahs.nsw.gov.au
Jorm
A F
AF
Knox
S
S
Braddock
D
D
Dear
K B G
KB
Britt
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D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D001315:Australia / Q000453:epidemiology; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008605:Mental Health Services / Q000592:standards / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D016730:Program Development; D015397:Program Evaluation; D019035:Rural Health Services / Q000592:standards / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000592:standards / Q000706:statistics & numerical data*
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives