The impact of service wait times on General Practitioners' treatment of adolescent depression and anxiety

Background General Practitioners (GPs) play a key role in referring adolescents with depression and/or anxiety to mental health specialists and services, but their capacity to do so may be compromised by service wait times. There is no standardised reporting of wait times for mental health specialists and services in Australia, and it is unclear how GPs manage the care of adolescents when the choice of treatment is not available. Aim To explore GPs’ self-reported referral practices to mental health specialists and services for adolescent depression and/or anxiety in Australia, as well as their perceived knowledge, acceptability, and impacts of the wait times for these. Design, Setting and Methods A cross-sectional online survey of 192 GPs in Australia who self-identified as treating adolescents (12 to 17 years old) with depression and/or anxiety. Results GPs most frequently referred adolescents with depression and/or anxiety to psychologists. The mean estimated wait time for psychologists was 57.26 days (SD: 47.91, Mdn: 45.0, range: 5-365), which was four times their perceived acceptable wait time (M: 14.66 days, SD: 8.70). Almost all GPs (81.8%) had increased their level of care due to long waits but reported limited training in adolescent mental health and limited knowledge of appropriate self-management strategies for the wait time. Conclusion GPs in Australia lack information on the wait times for adolescent mental health specialists and services, despite frequent referrals. Greater knowledge of wait times, training in wait time strategies, and self-directed digital interventions may help to enhance the quality of primary care provided to adolescents. STRENGTHS & LIMITATIONS This is the first study to examine GPs’ knowledge of wait times for mental health specialists and services for adolescents with depression and anxiety in Australia. GPs were found to have little knowledge of the anticipated wait times of mental health specialists and services, despite frequent referrals. This study may not adequately represent the diversity of GPs across Australia or capture the full spectrum of challenges or treatment practices used by GPs due to the sample size and self-report nature. Future research should aim to replicate these findings using objective data and explore whether there are GP or patient profiles that may be at greater risk of negative effects during the wait time. Additionally, qualitative methods, such as semi-structured interviews, may provide a richer scope of understanding of the impact of wait times on GPs and their rationale for treatment selection.