PARC Publications

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Models of Primary Health Care Psychotherapy and Counselling
(2008-10-12T01:51:59Z) Jackson-Bowers, Eleanor; Holmwood, Chris; McCabe, Damian
This review looks at psychotherapy and counselling services in primary health care provided by persons from the Allied Health Professions. The report makes a number of recommendations regarding location of the service, fundholding and employment, practitioner support, reporting and confidentiality.
Mental Health Programs in Remote Divisions of General Practice: PARC Knowledge Harvesting Program Issues Report
(2008-10-12T02:20:55Z) Osman, Elizabeth; Wade, Victoria; Jackson-Bowers, Eleanor
This discussion paper describes the mental health activities of Divisions of General Practice (DGPs) operating in remote areas of Australia , and documents the knowledge of the people who work in these programs.
Comorbidity in General Practice
(2008-10-12T02:43:00Z) McCabe, Damian; Holmwood, Chris
There is a definite role for GPs in providing care for people with coexisting substance use and mental health problems. However, the current level of care being provided by GPs is inconsistent and a number of areas for improvement have been identified. The PARC comorbidity project has explored issues regarding the approaches that GPs use when faced with patients experiencing comorbidity difficulties. The ultimate aim of this project is to improve the level of care provided to people with coexisting mental health and substance use problems by establishing positive changes in the management of comorbidity in the general practice setting. The first step is to establish what the management ought to be. The PARC Comorbidity Project conducted a review of the activities of the Divisions of General Practice in the area of comorbidity, and identified key issues in the identification and management of people with coexisting mental health and substance use problems in the general practice setting. It consulted with GPs, consumers and other health-care professionals to determine pragmatic ‘best practice’ approaches to the detection, assessment and treatment of comorbidity in the general practice setting, established a set of basic principles that will guide GPs in providing care for patients experiencing comorbidity difficulties and identified key areas of change to enhance the level of care provided to people with coexisting mental health and substance use problems in general practice.
Comorbidity of mental disorders and substance use: A brief guide for the primary care clinician
(2008-10-12T03:30:02Z) Holmwood, Chris
Comorbidity or the co-occurrence of mental disorders and substance use disorders is common. However there are significant problems with the management of people with comorbidity and a dearth of evidence about best practice. This resource has been developed as a result of work that PARC undertook in 2001 with the development of a set of principles for the management of people with comorbidity. These principles are outline at the start of this resource. More detailed information about specific aspects of management of the different types of co-existing mental disorders and substance use problems then follows. The information available is patchy and much of it is not based on high levels of evidence. In addition many people with co-morbidity have more than one mental disorder and may have problematic use of several drugs. This resource is a simple guide for clinicians to start to work.
Mental Health Shared Care in Australia 2001: Report for the Commonwealth Department of Health and Aged Care
(2008-10-12T03:50:22Z) Holmwood, Chris; Groom, Grace; Nicholson, Sally-Anne
This study provides a summary of the current policy and research literature on shared care and comments on the current debates around workforce, training and better coordination and integration of care between general practice and mental health services. It contributes to the knowledge base on the current state of mental health care reform in Australia. The review focuses specifically on better ways of integrating mental health care across the general practice and specialty mental health sectors and provides commentary on the points of influence, key players and social, political and economic events, which together have reshaped the culture of mental health care in Australia. Particular attention is paid to key national policy events in Australian general practice and the specialist mental health sector in the last decade, and how policy makers in both contexts have been influential in shaping a shift in emphasis from an isolationist service delivery model to one of partnership and community-based mental health care.
GPs and Psychiatrists Working Together: Literature Review
(2008-10-12T04:04:56Z) Jackson-Bowers, Eleanor
This literature review is about general practitioners and psychiatrists working together in the interest of their patients, how it has been done over the last twenty or so years and what has been learned. What has become clear with this review is that General practitioners and psychiatrists do not work in isolation. Both are dependent on systems of remuneration, fee-for-service and Medicare in the case of GPs and private psychiatrists, Government funding from many different ‘buckets’ for the Divisions of General Practice and State Mental Health funding in the case of publicly employed psychiatrists and mental health workers. Thus working together involves the interaction of professional cultures, systems and bureaucracies, not to mention pharmaceutical companies.
General Practitioners' peer support needs in managing consumer's mental health problems: A literature review and needs analysis.
(2008-10-12T04:11:23Z) Jackson-Bowers, Eleanor; Holmwood, Chris
Looks at current arrangements for peer support/supervision in Australia in a number of professions which undertake psychotherapy. .A number of different models and issues are examined. The need for peer support/supervision for GPs undertaking psychotherapy is also assessed and an argument is made for its necessity.
Major issues facing primary care mental health in Australia 2001
(2008-10-12T04:19:19Z) Holmwood, Chris
There are many unanswered research questions regarding mental health in the general practice setting. These need to be adequately researched to inform policy and reform. Developments in services should not be stalled by the fact that there are still many unanswered questions. There are plenty of opportunities for true innovation in the primary care metal health arena. The general practice workforce has an important role in managing these disorders but cannot do it alone. Further development though Divisions needs to be done in a measured way and needs to engage Divisions and their members and meet their agendas firstly. The development of three way partnerships between consumers, GPs and specialist services is essential to future success.

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