The perceived need for mental health care is only going up, despite extensive expansion of services.
A new study co-authored by former RACGP president Professor Karen Price speaks to the need for better funding for long GP appointments, this time in the realm of low-acuity mental health need.
Published in the Australian and New Zealand Journal of Psychiatry, the article looked at demand for mental health support in 2021 among patients with and without a common diagnosed disorder and compared results with a 2007 survey.
All up, the authors found that the proportion of people who felt their mental health needs were not fully met had increased from 14% in 2007 to more than 20% in 2021.
“We’ve got the Better Access scheme, we’ve got psychiatrists, we’ve got GPs, we’ve got mental health nurses, we’ve got community-based health services, and yet the population is not necessarily represented by the service delivery,” Professor Price told The Medical Republic.
“It’s a workforce issue, ultimately, and it’s a social care issue.”
In real terms, Professor Price and co-authors estimated that the treatment gap amounts to around two million people.
While population need for social interventions had remained steady between 2007 and 2021, the proportion of people who had reported needing these forms of help but were not receiving it had increased from 65% to 80%.
“As a GP who’s at the front line, you generally do get the sense that people are more fractured,” Professor Price said.
“There are more diagnosable disorders, but there’s also this unmet need for a whole range of things.
“This is my issue – when we talk about mental health, people conflate that with mental illness, but those are two different things.
“A lot of us have angst, and we’ve probably rung a friend to vent about all the crap. Social media is full of venting. People need to talk to other people and just co-regulate themselves and manage these difficult days and difficult times and difficult things.
“If our community is not working as a community should, in all of that, and the government have tried to replace that community sense with services.”
It’s a problem that no amount of broad, one-size-fits-all services can fix.
“There’s a whole lot of philosophical discussions, and the government is pulling really big levers – but I think they’re using a top-down approach,” Professor Price said.
“And what we need to do is think about a bottom-up approach.
“What’s happening in our communities? What’s happening on the ground, at the front line, that we need to address?
“That will range from a whole lot of community-based social care, skill-based training, counselling, [et cetera].”
This is where the local GP comes in.
“I have patients who still go and see their psychologists, but they also come to me,” said Professor Price.
“And so you try and support them through that with skills-based, community-based support and listening skills.”
Related
As part of a separate research project, Professor Price and GP academic Professor Louise Stone investigated the caseloads of female GPs planning to retire or cut back on clinical work.
One of the recurring themes was that GPs felt burned out from seeing patients whose mental health needs were too complex for the available services, and effectively making less money than their peers doing more procedural work.
“GPs are very skilled in mental health, in particularly a certain level of mental health that perhaps the psychiatrists and the psychologists don’t see, and they might not see for a variety of reasons,” Professor Price said.
“One, it might be the patients may not be able to afford the gap, and a lot of these people are seen as vulnerable patients by us and given a rebate-only service.
“But that talks to the study that I did with [Professor Stone] about the women GPs who were saying, ‘I’ve had enough of seeing all these complicated patients [who are] too complicated for other services, or the other services are overwhelmed, or they can’t afford them, and I’m seeing them and I’m losing, based on the next door guy who’s seeing, [the time to see] five patients an hour, or six patients an hour’.”
The fix suggested by Professor Price will be familiar to readers.
“The government has only addressed acute care needs, and they think that access is all that matters,” she said.
“That’s an absolute fool’s errand.
“I’ve used that phrase before, and it applies both sides of politics.
“We need to have longer consultations for complex presentations.
“Both at AMA and the colleges have said it. Every overseas study has said that you need to have time with your primary care provider supported.”
“… But the government has just looked at access because, unfortunately, the government’s trade in points are votes, and if they can get up and say, ‘we’ve opened X many urgent care services’, it looks like they’re doing something.”
Australian & New Zealand Journal of Psychiatry, 17 December 2025
