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Speaker 1: It's the Happy Families podcast. It's the podcast for the

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Speaker 1: time poor parent who just wants answers Now.

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Speaker 2: This month is Mental Health Awareness Months. Good it's doctor

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Speaker 2: Justin Coilson here. And one of the things that has

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Speaker 2: been coming through our emails podcasts at Happy Families dot

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Speaker 2: com dotu and is a regular question that I get

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Speaker 2: from parents who are stressed out, tired out, exhausted, burned

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Speaker 2: out and worrying about their kids or their own mental

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Speaker 2: health is.

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Speaker 3: How do I get help?

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Speaker 2: It's really hard to get into a doctor. Getting into

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Speaker 2: a psychologist is almost impossible, and even when you can

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Speaker 2: get in, the costs are enormous. How do we get

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Speaker 2: the help that we need? All this month, as part

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Speaker 2: of Mental Health Awareness Month, Kylie and I have been

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Speaker 2: talking about topics related to our kids and ourselves and

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Speaker 2: mental health. And we've had a handful of really interesting

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Speaker 2: conversations with experts who can guide this conversation.

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Speaker 3: Around mental health.

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Speaker 2: But today a discussion with a GP from WA, a

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Speaker 2: man by the name of Andrew Leach. Andrew Leach is

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Speaker 2: a GP, a general practitioner in Perth, Western Australia. He's

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Speaker 2: been a GP for ten years and his specialty focus

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Speaker 2: is consulting with families around issues of family health and

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Speaker 2: mental health. It's been working with Emerging Minds upskilling GPS

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Speaker 2: in this area and also the Royal Australian College of

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Speaker 2: General Practitioners the RACGP, and he joins me now on

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Speaker 2: the Happy Families podcast. Andrew, it's so good to talk

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Speaker 2: to you. Thanks for taking some time out of your

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Speaker 2: busy schedule to help us out with some mental health

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Speaker 2: challenges for families.

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Speaker 1: Thanks Justin, It's great to be here and be part

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Speaker 1: of this podcast series.

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Speaker 2: There's a handful of questions that I want to approach

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Speaker 2: with all once, so I'm going to try and curb

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Speaker 2: my enthusiasm and just ask them one at a time.

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Speaker 2: Let's say I'm struggling with my own mental health, or

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Speaker 2: I have a child and I'm pretty sure there's something

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Speaker 2: that's just not developmentally where it is supposed to be.

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Speaker 2: Maybe I've got some concerns about ADHD or autism or

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Speaker 2: oppositional behavior. How do I get the help that I need?

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Speaker 2: The advice consistently is go talk to your GP, and

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Speaker 2: your GP will tell you what to do. Is that

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Speaker 2: the right thing for me to be saying? And if

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Speaker 2: that's the case. What happens when somebody gets in to

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Speaker 2: see you.

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Speaker 3: It is the right thing to be saying, justin.

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Speaker 1: But it's just not as simple as that, is it,

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Speaker 1: because it is so hard to get the GP to

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Speaker 1: see you in the first place. I guess gps are

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Speaker 1: all very busy now, and the GP that you need

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Speaker 1: to listen to, so the GP that sort of has

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Speaker 1: that understanding of what you might be going through. You know,

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Speaker 1: we all have different interests in general practice, and I know,

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Speaker 1: you know, whilst I'm really passionate about this area, there'll

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Speaker 1: be other gps that are more interested in skin or

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Speaker 1: you know, women's health or men's health and might not

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Speaker 1: be as attuned into what ADHD or autism is. So

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Speaker 1: it's getting that first point of call you're finding. That

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Speaker 1: first sort of step is finding the right GP for

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Speaker 1: you and your family. I don't think gps would be

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Speaker 1: offended by you trying a couple just to get the

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Speaker 1: right one for you and your family often helps if

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Speaker 1: the GP does have children themselves as well, and that's

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Speaker 1: not that's a very generalized statement, but I know the

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Speaker 1: gps have got children often have that sort of bit

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Speaker 1: of life experience behind them where they've had those challenges

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Speaker 1: with parenting, where they've seen it and they know the

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Speaker 1: developmental milestones and they and they've to me that was

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Speaker 1: such a big education to have that.

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Speaker 3: Parenting life background.

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Speaker 1: But it's not just that. You know, some gps have

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Speaker 1: done extra training in pediatrics and they might have done

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Speaker 1: a child health diploma, and that can be a bit

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Speaker 1: of a clue that they have an interest and that

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Speaker 1: they usually put that on their website, on the clinic website.

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Speaker 1: So it is challenging, it's not easy. And often the

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Speaker 1: ones that are good at pediatrics or good at mental health.

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Speaker 3: Are the busiest ones as well. They're the ones that

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Speaker 3: are hard to get into because a lot of their.

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Speaker 1: Consults are longer and they then sort of have a

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Speaker 1: longer wait time to get in. But you know, it's

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Speaker 1: that's that's the system that we have to deal with.

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Speaker 1: What I always suggest to parents is right down your concerns.

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Speaker 1: So do a little bit of background work before you

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Speaker 1: come in. Write down what's going on for you. It's

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Speaker 1: really good for parents to list the problems send them

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Speaker 1: into the doctor before you go in, and that way

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Speaker 1: we have a bit of a heads up as to

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Speaker 1: what might be going on. The parent then has an

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Speaker 1: opportunity to outline their concerns without the child in front

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Speaker 1: of them. So there might be things they really don't

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Speaker 1: want to mention in front of the child, and we

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Speaker 1: don't want the child to feel this is all about

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Speaker 1: the problems that they're having. We want the child to

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Speaker 1: feel there might be some challenges, and I'm very open

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Speaker 1: with talking with children about some of the challenges, but

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Speaker 1: some of these issues are far more complex than what

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Speaker 1: the child needs to know.

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Speaker 3: So list the.

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Speaker 1: Problems send them in. That might prompt the GP to say, look,

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Speaker 1: you need to come in earlier. The other thing with

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Speaker 1: finding a GP is find the GP.

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Speaker 3: That likes to include the child in this process.

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Speaker 1: I'm really big on training gps to make sure the

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Speaker 1: child is included, and that means they are the center

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Speaker 1: of the console.

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Speaker 3: They are the patient.

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Speaker 1: That's the reason that the parent is in is because

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Speaker 1: of their child, the concerns about their child. So quite

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Speaker 1: often I'll spend the first ten minutes just talking to

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Speaker 1: the child. And this is obviously age dependent, depends on

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Speaker 1: how shy the child is when they come in.

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Speaker 3: It might take a lot of report building.

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Speaker 1: We often just talk about the fun stuff first, what

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Speaker 1: they like, their interests, their school friends, you know, what

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Speaker 1: they play outside school. But it takes that extra effort

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Speaker 1: for us, but it is worthwhile doing, is including the child,

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Speaker 1: because then when you've opened up that rapport, you can

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Speaker 1: delve into some of the deeper, more useful information. Quite

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Speaker 1: often when we're just talking about those general things as well,

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Speaker 1: like friendships, like school, we hear clues about what might

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Speaker 1: be going on that are difficult for the child. You know,

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Speaker 1: I don't have any friends, or I don't like school.

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Speaker 3: I hate school. That's a good clue for me. You know,

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Speaker 3: why do you hate school? What's going on?

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Speaker 1: What's going on at school that you hate about it?

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Speaker 1: So it's just that chit chat, that early report, or

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Speaker 1: hearing a bit about the journey and listening the GP

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Speaker 1: who listens to the parent is such a good GP.

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Speaker 3: It's just listening the feedback. I gad is.

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Speaker 1: All I wanted was just to let all this information out, just.

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Speaker 3: To let it off my chest.

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Speaker 1: I've really struggled for so long and not really been

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Speaker 1: able to know who to talk to.

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Speaker 2: So as you're answering that question and sharing those ideas,

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Speaker 2: I'm imagining a lot of parents are going, yeah, my

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Speaker 2: GP's never done anything like that. Let me ask you

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Speaker 2: a provocative question around this topic, Andrew, I would imagine

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Speaker 2: that from time to time, maybe even frequently, as you're

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Speaker 2: talking with the parent, talking with the child, trying to

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Speaker 2: understand really what's at the heart of the challenge, you

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Speaker 2: might feel you might discover that the child would probably

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Speaker 2: be doing better if there was more effective parenting happening.

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Speaker 2: That is, the child probably doesn't have autism, probably doesn't

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Speaker 2: have ADHD, probably isn't dealing with anything that's diagnosable.

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Speaker 3: What we're really dealing with.

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Speaker 2: Is a parenting issue. How do you communicate that with

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Speaker 2: a parent and in a way that makes them responsive

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Speaker 2: and receptive to you actually continuing to work with them

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Speaker 2: and guide them.

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Speaker 1: First of all, holding no judgment and letting parents know

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Speaker 1: there is no perfect way to parent and that we

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Speaker 1: all make mistakes. And I love normalizing it. In fact,

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Speaker 1: I love bringing in some of my own examples of

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Speaker 1: when I've had a difficult moment with my daughter. You

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Speaker 1: know how I sometimes get overwhelmed, and how I sometimes

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Speaker 1: snap and react, And it's human. It's a very it

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Speaker 1: can be very intense at home. Sometimes it can be emotional,

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Speaker 1: and I think just normalizing it and also letting parents

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Speaker 1: know I'm seeing this every day. I'm seeing parents who

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Speaker 1: are struggling and having those moments of you know, despair

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Speaker 1: on a daily basis, you are not alone. And then

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Speaker 1: also I like to ask, in sort of a general way,

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Speaker 1: how do you react when your daughter or child's is screaming, angry, agitated,

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Speaker 1: melting down in the shops or at home or school.

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Speaker 3: How do you react?

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Speaker 1: I just want to know what sort of way you

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Speaker 1: deal with that, and that then helps me to understand

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Speaker 1: is that an effective method or can we work on

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Speaker 1: trying some other strategies. Now, gps are not typically trained

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Speaker 1: in parenting psychology, you know that sort of CBT cognitive

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Speaker 1: behavior therapy, but I think we can offer some pearls

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Speaker 1: and little tips and I think we're pretty good at

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Speaker 1: picking up when things aren't going well. And that's the

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Speaker 1: other thing is we often know the whole family. So

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Speaker 1: we often then see dad, or we see Mum, or

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Speaker 1: we see the siblings, the grandparents even and we get

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Speaker 1: to know that whole family unit, which is really helpful

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Speaker 1: because we know if Mum has some mental health challenges,

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Speaker 1: and we know if dad's really struggling with his emotions,

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Speaker 1: or he's working away a lot, and you know the

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Speaker 1: challenges that brings. So we can then start to help

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Speaker 1: the family as a whole and follow them up over time.

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Speaker 2: Andrew, when you sit down with a parent, you discover

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Speaker 2: that there is definitely some additional assistance and support required.

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Speaker 3: What's the process?

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Speaker 2: So let's say we're talking to a family and you

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Speaker 2: think this kid definitely needs to have some diagnostics carried out,

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Speaker 2: or this parent needs a level of support for their

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Speaker 2: own mental health issues, or they're just their parenting challenges.

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Speaker 2: What happens then, because most parents will say I can't

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Speaker 2: afford one hundred and eighty or two hundred and twenty

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Speaker 2: bucks every fortnight to go and see the psychologist. And

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Speaker 2: the reality is sometimes psychology work takes a while. I mean,

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Speaker 2: this can be a really expensive exercise. How do you

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Speaker 2: guide a parent to the support that they need. What's

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Speaker 2: the mental health plan process?

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Speaker 3: Yeah?

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Speaker 1: So it is costly and it is time consuming. I

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Speaker 1: would say that if the GP is concerned about a diagnosis,

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Speaker 1: to ask them to help you do a mental health

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Speaker 1: care plan that does provide some funding. There are gps

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Speaker 1: out there, and I understand this that might be hesitant

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Speaker 1: to do a mental health care plan on a child

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Speaker 1: because they're not certain about the diagnosis or they think

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Speaker 1: there might not be a diagnosis. But just keep explaining

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Speaker 1: that the challenges are ongoing, and as I said earlier,

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Speaker 1: you find the GP that will help you with this

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Speaker 1: process because it can be done, and it should be

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Speaker 1: done if you need that sort of also financial support.

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Speaker 1: But the other great thing about that mental health care

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Speaker 1: plan is that provides that link then to the psychologist.

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Speaker 1: It can also be used for an OT with a

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Speaker 1: mental health background or a social worker. A lot of

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Speaker 1: gps don't know that, So find the right person for you.

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Speaker 1: Get the mental health care plan done. That then provides

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Speaker 1: some funding for six sessions to start with to one

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Speaker 1: of those allied health providers. It can then be extended

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Speaker 1: to ten. It doesn't cover the entire cost, as you said,

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Speaker 1: justin some psychologists will charge two hundred and two hundred

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Speaker 1: and fifty dollars. It might mean that you have to

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Speaker 1: do some research on more affordable psychologists, and they.

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Speaker 3: Are out there.

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Speaker 1: There are a few, but they're often busier. But the

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Speaker 1: mentalth plans a good starting point. Once we've got that link.

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Speaker 1: Then I often get feedback from the psychologists about how

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Speaker 1: things are going, and we get a letter back, and

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Speaker 1: we can then open that communication and keep working on

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Speaker 1: and refining if there is a diagnosis, if there is

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Speaker 1: a neurodevelopmental disorder going on as well, you know that

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Speaker 1: we might be starting to think about referring on to

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Speaker 1: a pediutrician.

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Speaker 3: Andrew.

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Speaker 2: When I listen to this process, it all sounds seamless,

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Speaker 2: it all makes sense, but we know that life's kind

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Speaker 2: of messy.

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Speaker 3: We know that it's.

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Speaker 2: Really hard to get into a GP, let alone quote

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Speaker 2: unquote the right one. Then you get these six visits

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Speaker 2: to a psychologist. But one thing that we know from

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Speaker 2: research is that the therapeutic alliance, that is the relationship

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Speaker 2: between the psychologist and the client is one of the

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Speaker 2: biggest indicators of how will that client works through managers

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Speaker 2: and even recovers when we're talking about their mental health challenges,

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Speaker 2: those difficulties that they're experiencing. If I go and see

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Speaker 2: a psychologist and I've got to wait three months to

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Speaker 2: get in, if I'm lucky, it's probably going to be

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Speaker 2: more than that. But let's say I geting because of it,

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Speaker 2: says Oh, this one's great, and it just doesn't feel right.

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Speaker 2: Am I now down to five with the next psychologists?

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Speaker 2: Or does it revert to six so that I can

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Speaker 2: try again? You're down to five, right, And so the

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Speaker 2: idea that and this is where it starts to get

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Speaker 2: complex because long wait times, you don't really know what

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Speaker 2: you're getting. Just because everyone else said he or she

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Speaker 2: is great doesn't mean that they're going to be great

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Speaker 2: for you. What's safety in there? What support? What other

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Speaker 2: advice can you offer? When a parent tries maybe two

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Speaker 2: or even three psychologists to get the right relationship, the

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Speaker 2: right alliance, to get the right opportunities for progress, how

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Speaker 2: do they get there?

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Speaker 1: It's a really great question justin the challenge there is

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Speaker 1: you are using up the sessions on the mental health

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Speaker 1: plan for each psychologist that you visit. It's not uncommon

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Speaker 1: for parents to find the first one is not the

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Speaker 1: right one. And I tell them not no one's offended

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Speaker 1: by that. That it's okay to say, look, we're just

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Speaker 1: not clicking, or this psychologists just doesn't have the interest

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Speaker 1: area that we were seeking.

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Speaker 2: And so hard to know after like an how long

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Speaker 2: visit as well.

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Speaker 1: It's so hard to know and often that first session

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Speaker 1: is just taking a history, so there's not much therapy

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Speaker 1: going on in that first session or even the second session,

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Speaker 1: and so parents will come back to me saying, you

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Speaker 1: just spent an hour talking to me about what was

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Speaker 1: going on, which is what you did, and I will

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Speaker 1: say they needed to.

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Speaker 3: Find that out.

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Speaker 1: So oh, look, I actually think it's good to give

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Speaker 1: them a go, give them a chance to connect. I

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Speaker 1: find it hard to connect in half an hour or

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Speaker 1: even fifteen minutes with the child. Give them a chance

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Speaker 1: to build the rapport. And if that five six sessions

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Speaker 1: is not working out, look it is tricky. There's no

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Speaker 1: way around Medicare to try and reset that except to

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Speaker 1: say that it resets each year, so it'll start again.

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Speaker 1: There are a further four sessions, so that takes you

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Speaker 1: up to ten. During COVID, we were really lucky to

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Speaker 1: have twenty sessions that we could use and they can

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Speaker 1: be changed between psychologists. But I have a feeling that

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Speaker 1: funding is about to be cut unfortunately, so it's going

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Speaker 1: to come back to ten sessions. Look at private health

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Speaker 1: insurance options. If you do have private health insurance, some

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Speaker 1: will fund part of that amount. But look, it's not

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Speaker 1: just the psychologist. It's not just the GP. There are

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Speaker 1: other supports that you could be seeking in that time

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Speaker 1: that you're waiting to get the right help. And I

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Speaker 1: tend to get that pediatric referral early. If I think

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Speaker 1: there is a neurodevelopmental disorder in wa, we're having a

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Speaker 1: real issue getting a pediatrician for children. It takes a

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Speaker 1: long time. It can take parents twelve plus months to.

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Speaker 3: Get a pediatrician.

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Speaker 1: So get that referral early and get in the wait

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Speaker 1: lists of the pediatricians. I really love to involve the teacher.

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Speaker 1: The teacher is spends half the time with the child.

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Speaker 1: So how do I involve the teacher. I'll send them

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Speaker 1: an email, say, look, little Johnny's having trouble with his feelings,

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Speaker 1: his emotions. I am wondering about also ADHD or I'm

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Speaker 1: wondering about a mental health disorder. Can you just keep

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Speaker 1: an eye out for him and maybe have a look

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Speaker 1: at some ways around supporting him in the classroom. You know,

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Speaker 1: I don't like telling teachers what to do, because they

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Speaker 1: know the children best and they know what works well,

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Speaker 1: and they're busy too, But just letting them know, just

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Speaker 1: flagging it with them.

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Speaker 2: Yeah, I love I love it because parents probably don't

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Speaker 2: usually know that they can ask the doctor to give

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Speaker 2: them some kind of information to pass on to the tea.

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Speaker 1: Yes, yes, and I will get a letter back from

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Speaker 1: the teacher saying thank you, thank you for raising this.

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Speaker 1: I'm going to keep you in the loop about how

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Speaker 1: how this child is going. And I love that because

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Speaker 1: then we're sort of starting to create a little team

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Speaker 1: around the child. There's there's other ways as well. You know,

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Speaker 1: it might be it might be getting the child to

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Speaker 1: enroll in a in a social group or a sports

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Speaker 1: program or something that helps build their social skills and confidence,

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Speaker 1: and that is therapeutic. Enrolling in your program, Justin. I

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Speaker 1: tell them all all in Justin's program. That is a

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Speaker 1: nice bridge towards towards that psychology appointment that you're waiting for,

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Speaker 1: or in between psychology appointments. And there's a few other

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Speaker 1: online cognity behavior programs like the Brave program that is

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Speaker 1: really great for anxiety in children, which is online. So

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Speaker 1: just just little things on the way and keep coming

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Speaker 1: back to GP.

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Speaker 3: You know.

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Speaker 1: I encourage parents to book in at least once a

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Speaker 1: term for a long appointment to touch base and let

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Speaker 1: me know how they're going, and if they're really struggling

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Speaker 1: with that psychologist or finding the right person, we'll just

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Speaker 1: keep working on it. That's all we can do, really,

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Speaker 1: and looking for alternatives that might help with that child's journey.

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Speaker 3: Yeah.

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Speaker 2: I like that. Just keep working on it. It's kind

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Speaker 2: of the mantra for life, isn't it so, Andrew? If

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Speaker 2: I was to summarize, basically, when you're worried about your

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Speaker 2: own mental health or that of your children, get in

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Speaker 2: see the GP to the extent that you can find

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Speaker 2: a GP who's going to be trained in mental health

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Speaker 2: or pediatrics, or a combination of the two. Get on

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Speaker 2: the mental health care plan. Hopefully find a psychologist. Hopefully

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Speaker 2: find a psychologist that you can have a good relationship

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Speaker 2: with as well, so that you just it's not about

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Speaker 2: just finding a site, it's about getting the relationship right.

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Speaker 2: And then continue the communication, continue the progress. Talk to

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Speaker 2: the teacher, bring that alliance of people together, the occupational

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Speaker 2: therapist or the social worker or just somebody else. And

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Speaker 2: I love what you said right at the end. Get

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Speaker 2: the kids outside, get them involved in sports, get them

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Speaker 2: being physically active, get them doing the stuff that we

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Speaker 2: know is associated with great health.

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Speaker 1: One of my biggest tips is turn off the screens

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Speaker 1: and go outside and play and go back to sort

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Speaker 1: of the basics good sleep, eating well and play and

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Speaker 1: social skills and getting them you know, get invite a

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Speaker 1: friend over. You know, some of those basics are so

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Speaker 1: powerful for child mental health that you know, we often

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Speaker 1: end up not needing that extra support because we're figured out.

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Speaker 1: It's made it a lot easier. I know it's not

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Speaker 1: that simple, but it's just just those practical things that

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Speaker 1: sometimes we forget as parents because we are also overwhelmed

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Speaker 1: and busy and just to finish. Also, Justin, parents can

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Speaker 1: also access the mental health care plan for themselves if

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Speaker 1: they are also struggling with a mental health diagnosis or illness.

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Speaker 1: So you know, it's not uncommon for me to get

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Speaker 1: the parent back for them to also referred on to

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Speaker 1: a psychologist, and I think that is really important that

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Speaker 1: they are supported as well, and that helps with the

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Speaker 1: whole family network.

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Speaker 2: Terrific Andrew, great talking to you, Thanks so much.

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Speaker 1: Thanks Justin. Great to be part of the program.

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Speaker 2: Andrew Leach is a GP based in Perth, Western Australia.

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Speaker 2: I kind of wish that he was just down the

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Speaker 2: road from me. I think it'd be handy to have

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Speaker 2: a GP like Andrew around if you'd like more information

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Speaker 2: about the things that we've talked about, heaps of information

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Speaker 2: you'll find that in the show notes. We'll link to

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Speaker 2: all of the different resources that Andrew has highlighted as

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Speaker 2: we've discussed things throughout this podcast. And if you like

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Speaker 2: more information about me your family happier. We love it

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Speaker 2: when you check out Happy families dot com dot au.

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Speaker 2: The Happy Families podcast is produced by Justin Ruland from

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Speaker 2: Bridge Media. Craig Bruce is our executive producer.

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Speaker 3: Tomorrow, on the podcast book Club

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Speaker 2: We only get to do it once a month, and

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Speaker 2: Tomorrow it's the day Kylie and I are going to

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Speaker 2: let you know the best stuff we've read over the

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Speaker 2: last month