A cross-sectional survey of general practitioners’ perspectives on wait times for adolescent mental health specialists and services in Australia

BACKGROUND: General practitioners (GPs) are often the first point of professional contact for Australian adolescents experiencing depression and anxiety, and play a central role in facilitating access to specialist mental health care. However, increasing demand and constrained service availability have resulted in prolonged wait times. Little is known about how GPs manage adolescent mental health care during these delays. This study explored Australian GPs' experiences of wait times for adolescent mental health services, including referral practices, access to wait time information, perceived impacts of delays and strategies used to support adolescents while awaiting treatment. METHODS: A national cross-sectional online survey was conducted between May and November 2022 with Australian GPs who treated adolescents aged 12-17 years with depression and/or anxiety. Survey items examined referral practices, estimated and acceptable wait times, access to wait time information, perceived impacts of delays, and interventions recommended during waiting periods. Descriptive statistics, ordinal correlations and thematic analyses of free-text responses were conducted. RESULTS: The final sample comprised 190 GPs (71.6% female; mean age 42.38 years, s.d. 10.25). Most frequently treated adolescents with depression and/or anxiety, and 80.0% reported increased presentations over the previous year. GPs most commonly referred adolescents to psychologists (92.1%), and frequently recommended ongoing GP appointments and lifestyle modifications. Estimated mean wait times ranged from 24 days for inpatient services to 113 days for psychiatrists, substantially exceeding GPs' proposed acceptable waits of 7-26 days. Most GPs considered wait times for psychologists (86.7%) and psychiatrists (89.4%) unacceptable. Most GPs increased their level of care during prolonged waits (82.1%), and perceived delays as contributing to symptom deterioration, treatment disengagement, reduced help-seeking and increased self-harm or suicide risk. Despite viewing interim support as highly important, most GPs rated their knowledge of effective wait time strategies as only basic or adequate. CONCLUSIONS: Australian GPs are providing substantial interim mental health care for adolescents during prolonged delays to specialist treatment within a constrained system. Improving youth mental health system capacity, alongside strengthening GP training, resources and access to evidence-based supports, may improve care during extended waiting periods.