Western Australia's First and Regional General Practitioner Psychiatry Phone Line to Improve Primary Mental Health Care: Indicators of Effectiveness and Sustainability: A Non-Controlled Population-Based Interventional Study

Objective(s)

To assess the impact of a regional General Practitioner Psychiatry Phone Line (GPPPL), embedded in a public Community Mental Health service (CMHS) on the wider health service's workflow and systemic outcomes.

Design

Non-controlled population-based interventional study.

Setting

Public CMHS in the Great Southern region of Western Australia (WA).

Participants

Aggregated monthly data on (i) referrals to the CMHS (July 2017–March 2022), and (ii) Emergency Department presentations (July 2017–May 2022) were obtained from the West Australian Country Health Service.

Intervention

Introduction of a regional GPPPL, for local publicly employed psychiatrists to provide specialist mental health care advice to General Practitioners working in the same region.

Main Outcome Measures

Service input: Number of calls to the GPPPL, call duration and frequency.

Service output: Rate of referrals to the CMHS, and rate of Emergency Department presentations related to mental health issues, and alcohol and other drugs.

Results

The number of weekly calls to the GPPPL decreased (slope −0.13, 95% CI −0.17, −0.08; p < 0.0001) over the course of the one-year pilot. The referral rate to CMHS was approximately 70.5 referrals per 1000 person-years in July 2017, and quite steady pre-GPPPL (p = 0.9283), then reduced significantly post-GPPPL, by 1.7 (95% CI 0.14, 3.26; p = 0.0372) referrals per 1000 person-years each month.

Conclusions

This study has demonstrated the GPPPL's effectiveness in reducing the referral rates to CMHS and its self-sustainability. The psychiatrists involved were able to continue full-time public service roles while running the phoneline, with a decreasing time demand over the one-year pilot.