Psychiatric disorders are very common. A recent survey of Australian households showed a point prevalence of 14% and an incidence in one year of 23%. There are insufficient numbers of psychiatrists to treat all these patients and referrals will therefore need to be selective. The decision to refer is influenced by the general practitioner’s interests, training and experience with psychiatric disorders. Many patients (approximately 75% of those with formal psychiatric disorders) are largely managed by general practitioners.
- Some patients presenting with psychiatric emergencies need to be referred to public sector services, particularly when involuntary treatment may be required. Uninsured patients requiring admission will also need to be referred to the public sector. General practitioners will usually find themselves initially discussing these referrals with mental health professionals other than psychiatrists. Psychiatrists exist in small numbers in most public sector services and are mostly involved in secondary and tertiary consultation.
- Access to private psychiatrists is often difficult because of their heavy caseloads. Psychiatrists with long waiting lists for patients seeking ongoing care may be able, if asked, to see patients urgently for assessment and an opinion only. They then may be able to give advice aimed at helping general practitioners to manage their patients themselves.