In Western Australia, up to nine in 10 patients with mental health conditions have at least one recorded risk factor or risky health behaviour, new research shows.
Patients with multiple mental health conditions make more than three times as many GP visits as those without, a new report on general practice data finds.
The report, released today, was produced in collaboration between WA Primary Health Alliance (WAPHA) and the AIHW.
It drew on de-identified general practice records from 430 WA practices between July 2017 and June 2024, collected using the Primary Sense extractor, which is used by approximately half of Australia’s Primary Health Networks.
Researchers found WAPHA’s general practice data captured demographic patterns better than other national survey data, such as the National Health Survey.
“General practice data has significant potential to address current information gaps for national health reporting,” the report read.
People who had recorded mental health conditions were more likely than those without to also have one or more of the six most commonly seen physical health conditions in general practice (chronic lower respiratory disease, cardiovascular disease, type 2 diabetes, cancer, chronic liver disease, and chronic kidney disease.
The biggest gap was in type 2 diabetes, which affected 13% of patients with schizophrenia and/or affective psychosis, almost double the rate among those with anxiety, depression, and/or compulsive disorders (6.9%) and those without mental health conditions (6.7%).
Risk factors and health behaviours
People with two or more mental health conditions had the highest rate of at least one recorded biomedical risk factor (hypertension, obesity, being overweight, or high cholesterol) or health behaviour (smoking, risky alcohol consumption, or illicit drug use), at 91%.
Hypertension was the most common biomedical risk factor among people with a recorded mental health condition, falling between 50% and 60%, and was more prevalent than among those without one (45%).
Obesity was next, recorded for 38% of people with schizophrenia and/or affective psychosis – almost double the rate among those without these conditions (21%).
Half of people with a mental health condition were current or former smokers. Those with schizophrenia and/or affective psychosis were more than twice as likely (45%) to smoke as those without these conditions (21%).
Risky alcohol use was less common and varied only slightly across types of mental health condition.
Illicit drug use was recorded more often among people with mental health conditions than among those without (0.5%), and was highest among those with two or more conditions, at 15%.
Time in the consulting room
In 2023-24, people in WA with two or more mental health conditions had the highest median number of GP visits – 10 – more than triple that of those without these conditions.
The gap narrowed but persisted among patients with three or more physical conditions, peaking at 18 visits versus 12 for those with no mental health conditions.
People with schizophrenia and/or affective psychosis, and those with two or more mental health conditions, had the highest rates of chronic condition management items.
The project called for an improved understanding of disease expenditure estimates in general practice.
Among patients aged 75 and over, health assessments were most common among those with anxiety, depression, and/or phobia/compulsive disorders (37%), followed by those with schizophrenia and/or affective psychosis (35%). However, this was not much higher than among those without conditions (30%).
Interestingly, figures for patients with both types of condition were too small to publish.
Related
Who is affected?
Depression was the most common mental health diagnosis in WA in 2023-24, accounting for 5.1% of the study population, while those with two or more health conditions made up just 0.3%.
Women accounted for a higher proportion of patients with mental health conditions across WA general practice – most markedly in anxiety, depression, and/or phobia or compulsive disorders.
Among 18 to 24-year-olds, anxiety, depression, and/or phobia or compulsive disorders were diagnosed far more often (13%) than schizophrenia and/or affective psychosis (6.8%).
However, incidence of anxiety, depression and/or phobia or compulsive disorders peaked among people aged 30 to 34, whereas schizophrenia and/or affective psychosis were most prevalent among those aged 40 to 44. Those with two or more conditions fell in between, aged 35 to 39.
The report forms part of the National Primary Health Care Data Collection project, which aims to fill existing data gaps in primary health care and enable comparisons with other primary care sectors.
“We will continue to develop general practice data to provide population health insights,” the report read.
RACGP-specific interests in psychological medicine chair Dr Karen Spielman said the statistics reinforced what GPs were seeing “every day” in practice and affirmed the importance of policymakers acknowledging GPs’ contribution to mental health.
“Conversations about managing medication, physical health risks, coordinating care, and general support take time. We need to be able to us to address their holistic needs,” she said.
“Our patients need more time with their GP for mental health care, and Medicare needs to reflect that.”
Read the full report here and the NPHCDC data governance framework here.
