Developing Mental Health Skills Training (MHST) courses (Level 1)

Table of contents

Developing Mental Health Skills Training (MHST) courses (Level 1)

Objectives

Your MHST course must:

enhance GPs’ skills to recognise and assess mental illnesses so they can prepare evidence-based GP MHTPs
enhance GPs’ skills to monitor and review a patient’s progress
provide GPs with insight into the perspective of people who have experienced mental illness
provide GPS with insight into the perspective of non-professional carers caring for people living with mental illness.

Developing an MHST Primary Pathway course

The most common pathway GPs take to become accredited with MHST, the MHST Primary Pathway, is designed for:

general practice registrars and other doctors entering general practice in Australia
GPs who need a refresher on core mental health skills as part of their CPD.

Although experienced GPs can complete an MHST Primary Pathway course, we encourage GPs who have already completed MHST to complete courses in the MHST Modular Pathway so that they extend their skills in assessing and managing specific mental illnesses.

Course requirements of an MHST Primary Pathway course

Your MHST Primary Pathway course must:

be of at least six hours duration (whether an e-learning or a face-to-face course)
contain relevant predisposing components
contain relevant reinforcing components.

Useful GPMHSC resource

Developing Mental Health Skills Training (MHST).

Learning outcomes and course content of an MHST Primary Pathway course

Your MHST Primary Pathway course must adequately address each of the learning outcomes and course content items shown in Table 9.

Table 9. Learning outcomes and course content of an MHST Primary Pathway course

Learning outcomes for GPs	Course content The course must include:
1. Detect mental health issues experienced by consumers	1.1 a brief discussion of Australia’s mental health care system (which can be included in pre-reading) 1.2 a discussion of the epidemiology and aetiology of mental disorders included for treatment under the Better Access initiative (which can be included in pre-reading)
2. Assess and manage mental illness in the context of general practice	2.1 recognition of the physical and differential factors, causation and prevention in detecting mental illnesses in primary care 2.2 the application of skills required in mental health assessment, including: § interviewing skills § psychosocial history-taking § risk assessment (including risk of suicide and self-harm) § current psychosocial status and the effect of social determinants of health 2.3 the application of complexities and comorbidities often associated with mental illness 2.4 the use of psychometric instruments to aid mental health assessment and the identification of changes in symptoms 2.5 the reassessment and review of patients with a known mental illness, including the review of their GP MHTP
3. In consultation with consumers and carers, develop an agreed evidence-based and needs-based GP MHTP	3.1 a discussion with a consumer to achieve a shared understanding of the mental illness, considering cultural and linguistic diversity 3.2 a discussion with consumers and carers about psychoeducation and self-help strategies 3.3 the development of personal prevention strategies and plans to assist in detecting early warning signs of mental illness 3.3 a discussion about the appropriate and inappropriate use of evidence-based pharmacological and psychological therapies, either alone or in combination, for treating mental illness 3.4 a discussion about skills in shared care, multidisciplinary communication and teamwork
4. Develop a GP MHTP that incorporates the lived experience and needs of consumers, their carers and others in their network	Consumer experience 4.1 a discussion with the consumer about their experience of a diagnosis, including: § when first diagnosed § whether this diagnosis helped § whether the diagnosis has changed over time § the impact of the diagnosis and of the mental illness on the consumer’s life 4.2 a discussion of helpful and unhelpful aspects of their relationship with the GP and/or healthcare system, including previous experiences of barriers to accessing mental health services 4.3 a discussion of improvements that could be made to the primary healthcare system for consumers of mental health services, and recommendations to address barriers to access 4.4 a discussion of the value of the GP MHTP in terms of the consumer’s recovery 4.5 a discussion of useful resources for consumers Carer experience 4.6 a discussion of how the mental illness diagnosis of the consumer has affected the carer, their role as a carer, their life and their health and wellbeing 4.7 a discussion of how GPs can best support carers and other support people through the coordination of care 4.8 a discussion of the value of the GP MHTP and the carer’s role in the patient’s recovery 4.9 a discussion of improvements that could be made to the primary healthcare system for carers of people accessing mental health services, and recommendations to address barriers to access. 4.10 a discussion of useful resources for carers
5. Discuss the use of practice systems and strategies to provide safe and holistic mental health care in the context of general practice	5.1 the implementation of systematic approaches to risk assessment and coordination of care for consumers 5.2 the application of knowledge of local services, resources and referral pathways relevant to address consumers’ needs and their mental health care and recovery 5.3 the implementation of systematic approaches to manage the complexities of providing mental health care, including strategies that acknowledge and support GPs’ self-care and wellbeing
6. Discuss appropriate MBS item numbers relating to provision of mental health care in the context of general practice	6.1 the use of MBS item numbers and other GP mental health item numbers commonly used in general practice (including telehealth items) when developing and reviewing a GP MHTP

The MHST Modular Pathway course

Developed in response to the increasingly complex mental health issues that patients present with, this pathway is designed for more experienced GPs who have a particular interest in mental health.

Typically, this would be GPs who:

want to know more about mental health
consult many patients with mental illness.

By choosing the Modular Pathway, GPs can:

acquire core skills and knowledge in mental health, then
tailor their MHST learning according to special interests and needs by completing different clinical enhancement modules as part of MH CPD, thereby expanding their skills and ability to treat complex mental illnesses.

GP requirements

To satisfy the requirements of the MHST Modular Pathway, GPs must complete:

one core module (three hours) plus
one clinical enhancement module (four hours).

They do not have to complete the core module and the clinical enhancement module with the same training provider, nor do they have to complete the two modules on the same day.

Developing an MHST Modular Pathway course

As a training provider, you can develop and deliver:

a stand-alone core module
one or more clinical enhancement modules, each focusing on a different topic or area.

The requirements for each option are set out in the following pages.

Developing a core module

Your core module must cover the fundamentals of mental health care in Australian general practice, and include:

an overview of the Better Access initiative, mental health care services and resources available to GPs
the key components of a GP MHTP
a deeper understanding of mental illnesses commonly presented in general practice
an introduction of the concept of the consumer and carer perspective in providing mental health care.

Why GPs choose a core module

GPs complete a mental health core module if:

they want to claim MBS items 2715 and 2717, in which case they must complete this module, then a mental health clinical enhancement module
they require a refresher on core mental health skills, in which case they complete it as part of their MH CPD.

Learning outcomes and course content of a core module

Your core module must adequately address each of the learning outcomes and course content items shown in Table 10.

Table 10. Learning outcomes and course content of an MHST mental health core module

Learning outcomes for GPs	Course content The course must include:
1. Detect mental health issues experienced by consumers	1.1 a brief discussion of Australia’s mental health care system (which can be included in pre-reading) 1.2 a discussion of the epidemiology and aetiology of mental disorders included for treatment under the Better Access initiative (which can be included in pre-reading)
2. Assess and manage mental illness in the context of general practice	2.1 recognition of the physical and differential factors, causation and prevention in detecting mental illnesses in primary care 2.2 the application of skills required in mental health assessment, including: § interviewing skills § psychosocial history-taking § risk assessment (including risk of suicide and self-harm) § current psychosocial status and the effect of social determinants of health 2.3 the application of complexities and comorbidities often associated with mental illness 2.4 the use of psychometric instruments to aid mental health assessment and to identify change in symptoms 2.5 the reassessment and review of patients with a known mental illness, including the review of their GP MHTP
3. In consultation with consumers and carers, develop an agreed evidence-based and needs-based GP MHTP	3.1 a discussion with a consumer to achieve a shared understanding of the mental illness, considering cultural and linguistic diversity 3.2 a discussion with consumers and carers about psychoeducation and self-help strategies 3.3 the development of personal prevention strategies and plans to assist in detecting early warning signs of mental illness 3.3 a discussion about the appropriate and inappropriate use of evidence-based pharmacological and psychological therapies, either alone or in combination, for treating mental illness 3.4 a discussion about skills in shared care, multidisciplinary communication and teamwork
4. Discuss the use of practice systems and strategies to provide safe and holistic mental health care in the context of general practice	4.1 the implementation of systematic approaches to risk assessment and coordination of care for consumers 4.2 the application of knowledge of local services, resources and referral pathways relevant to consumers’ needs to assist in their mental health care and recovery 4.3 the implementation of systematic approaches to manage the complexities of providing mental health care, including strategies that acknowledge and support GP self-care and wellbeing
5. Discuss appropriate MBS item numbers relating to provision of mental health care in the context of general practice	5.1 the use of MBS item numbers and other GP mental health item numbers commonly used in general practice (including telehealth items) when developing and reviewing a GP MHTP

Developing a clinical enhancement module

Why GPs choose a clinical enhancement module

GPs choose a clinical enhancement module after completing the mental health core module and can choose the clinical enhancement module that suits their specific needs or areas of interest.

We encourage GPs to complete a range of mental health clinical enhancement modules as part of their MH CPD.

Requirements of a clinical enhancement module

A clinical enhancement module must:

build on the knowledge acquired in the core module
apply that knowledge to a specific mental health condition, or complex situations, or a specific consumer group (therefore it is more specific than the courses in the MHST Primary Pathway)
include carer and consumer perspectives relating to the specific mental illness/es covered.

Mental disorders addressed by a clinical enhancement module must be one or more of those specified in the Better Access initiative, so that GPs who complete the course (and have completed the core module) can:

create GP MHTPs
claim relevant MBS items.

Learning outcomes and course content of a clinical enhancement module

Your clinical enhancement module must adequately address each of the learning outcomes and course content items shown in Table 11.

Table 11. Learning outcomes and course content of a clinical enhancement module

Learning outcomes for GPs	Course content The course should contain:
1. Detect mental health issues experienced by consumers	1.1 a discussion of the epidemiology and aetiology of mental disorders included for treatment under the Better Access initiative (which can be included in pre-reading)
2. Assess and manage mental illness in the context of general practice	2.1 recognition of the physical and differential factors, causation and prevention in detecting mental illnesses in primary care 2.2 the application of skills required in mental health assessment, including: § interviewing skills § psychosocial history-taking § risk assessment (including risk of suicide and self-harm) § current psychosocial status and the effect of social determinants of health 2.3 the application of complexities and comorbidities often associated with mental illness 2.4 the use of psychometric instruments to aid mental health assessment and to identify change in symptoms 2.5 the reassessment and review of patients with a known mental illness, including the review of their GP MHTP
3. In consultation with consumers and carers, develop an agreed evidence-based and needs-based GP MHTP	3.1 a discussion with a consumer to achieve a shared understanding of the mental illness, taking into account cultural and linguistic diversity 3.2 a discussion with consumers and carers about psychoeducation and self-help strategies 3.3 the development of personal prevention strategies and plans to assist in detecting early warning signs of mental illness 3.3 a discussion about the appropriate and inappropriate use of evidence-based pharmacological and psychological therapies, either alone or in combination for treating mental illness 3.4 a discussion about skills in shared care, multidisciplinary communication and teamwork
4. Incorporate the lived experience and needs of consumers, their carers and others in a person’s network in a GP MHTP	Consumer experience 4.1 a discussion of the consumer’s experience of a diagnosis, including: § when first diagnosed § whether this diagnosis helped and has changed over time § the impact of the diagnosis and the mental illness more broadly on the consumer’s life 4.2 a discussion of helpful and unhelpful aspects of their relationship with the GP and/or healthcare system, including their experiences of barriers to accessing mental health services 4.3 a discussion of improvements that could be made to the primary healthcare system for consumers of mental health services and recommendations to address barriers to access 4.4 a discussion of the value of the GP MHTP from a recovery perspective 4.5 useful resources for consumers Carer experience 4.6 a discussion of how the mental illness diagnosis of the consumer has affected the carer, their role as a carer, their life and their health and wellbeing 4.7 a discussion of how GPs can best support carers and other support people via care coordination 4.8 a discussion of the value of the GP MHTP and the carer’s role in the recovery journey 4.9 a discussion of improvements that could be made to the primary healthcare system for carers of people accessing mental health services and recommendations to address barriers to access 4.10 a discussion of useful resources for carers
5. Discuss the use of practice systems and strategies to provide safe and holistic mental health care in the context of general practice	5.1 the implementation of systematic approaches to risk assessment and coordination of care for consumers 5.2 the application of knowledge of local services, resources and referral pathways relevant to consumers’ needs to assist in their mental health care and recovery 5.3 the implementation of systematic approaches to manage the complexities of providing mental health care, including strategies that acknowledge and support GP self-care and wellbeing