Abstract
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.