Your Mental Health and Alcohol: Managing the Mix Alcohol and Mental Health Comorbidity in Primary Care Project

Alcohol Misuse and Mental Health Comorbidity in General Practice
Alcohol and mental health problems are often linked, and community prevalence of these concurrent (or 'comorbid') conditions is common: about one in four people with an anxiety, affective or substance use disorder have at least one other disorder (Andrews et al, 1999). The high prevalence of comorbid alcohol misuse and common mental health problems such as depression and anxiety makes general practice a valuable health care setting to identify and treat these conditions. 

Relevant Policy Frameworks
Current national strategies in the alcohol, drugs and mental health arenas developed by Australian Health Ministers have all nominated primary health care as a key setting for the identification and treatment of comorbid alcohol misuse and mental health problems. 

In particular, the National Mental Health Plan 2003-2008 and the National Drug Strategic Framework describe the need to improve service responsiveness in the area of alcohol and mental health comorbidity. 

Some investment has also been made in better chronic disease management in general practice, such as SNAP trials, and in primary mental health care reform under the National Primary Mental Health Care Network and the Better Outcomes in Mental Health Care Initiative (where alcohol disorders are included as treatable disorders). 

Your Mental Health and Alcohol: Managing the Mix
A robust primary care response is a critical part of a comprehensive, quality approach to the care of people experiencing alcohol problems and common co-morbidities such as depression and anxiety. Building capacity and skills for better prevention and management of comorbidity in general practice has been a progressive process across relevant programs run by Divisions of General Practice such as drug and alcohol, mental health and youth health

Project Objectives
In order to strengthen the level and quality of care for people with comorbidity in the primary care setting, recent reviews suggest a number of steps need to be taken.  These include more systematic and integrated shared care programs, skills development for GPs in the area of addictions and mental health, clinical support for GPs and practice staff to respond to complex comorbid presentations, and appropriate consumer education resources for use in the GP consultation and/or surgery. 

The Project's primary objectives are to:

•  improve the knowledge, skills and capacity of the general practice sector in the prevention and management  of high prevalence alcohol and mental health comorbidities in primary care
•  build a critical mass of GPs and practice staff competent in the prevention, management and referral of alcohol and mental health comorbidity

Project Dimensions
The project has three domains of activity:

•  Development and dissemination of information, awareness and self-help resources for GPs, practices and consumers/carers for use in waiting rooms and consultations;
•  Skills training for GPs in the management and prevention of comorbidity linked to both existing professional accreditation and quality assurance requirements and peer support initiatives
•  Funding to individual Divisions or clusters of Divisions interested in being supported to pursue additional approaches such as building systems or models of collaborative care and strengthened referral pathways with local health and other providers.

Intended outcomes of the project include:

• Greater awareness in the general practice setting of the prevalence of alcohol and mental health comorbidity
• Strengthened screening by GPs for alcohol and mental health comorbidity
• Clinical approaches to comorbidity will be available to GPs in a way that relates to their setting
• A critical mass of GPs and practice staff  more confident in comorbidity identification and treatment
• Enhanced engagement between public drug and alcohol and mental health services and Divisions for shared care and specialist support
• Models of shared care and enhanced referral pathways
• Contributions to public health literature and relevant conferences

Project Partners
The Project is a government-community-general practice collaboration involving the Alcohol Education and Rehabilitation Foundation (AER), the Mental Health Council of Australia, the Australian Government Departments of Health and Ageing and Veterans Affairs, and Australian Divisions of General Practice (ADGP).  The Primary Mental Health Care Australian Resource Centre based at the Department of General Practice, Flinders University will manage the evaluation.     

The project is funded by the AER with financial and in-kind contributions from the Australian Government Departments of Health and Ageing and Veterans' Affairs. The Project is being co-ordinated by ADGP, with advice from an expert reference group.

19 projects, representing 33 Divisions of General Practice have been funded to implement Managing the Mix locally. For information on individual projects, see Project Summaries.

Divisions of General Practice funded under Managing the Mix
Division	State
NSW Central Coast	NSW
Central Sydney	NSW
Canterbury	NSW
Illawarra	NSW
Shoalhaven	NSW
NSW Outback	NSW
Top End	NT
Townsville	QLD
Capricornia	QLD
Adelaide Northern	SA
Yorke Peninsula	SA
Mid North	SA
Barossa	SA
GP North	TAS
Mallee	VIC
Bendigo	VIC
Murray Plains	VIC
Westgate	VIC
Western Melbourne	VIC
Dandenong	VIC
Greater South Eastern	VIC
Monash	VIC
Central Bayside	VIC
Eastern Ranges	VIC
Whitehorse	VIC
Inner Eastern Melbourne	VIC
Knox	VIC
Canning	WA
Perth Central Coastal	WA
Osborne	WA
Mid West	WA
Pilbara	WA
Eastern Goldfields	WA

For more information
Primary Mental Health Care Australian Resource Centre: http://som.flinders.edu.au/FUSA/PARC
Alcohol Education and Rehabilitation Foundation: www.aerf.com.au
Mental Health Council of Australia: www.mhca.com.au  

Contact
Slade Carter
Senior Program Officer
Australian Divisions of General Practice
Ph 02 6228 0846
Fax 02 6228 0899
E-mail scarter@adgp.com.au 

 

Subscribe to Page