We’re putting the spotlight on mental health in this new monthly feature. Learn more about SWSPHN commissioned services, projects and events, and find guidance on navigating the mental health system.
This month we spoke to Dokotela about the SWSPHN-funded Consultant Psychiatry Service.
What services and supports does your service provide?
The Consultant Psychiatry Service commissioned by South Western Sydney PHN provides brief intervention and care planning by a psychiatrist for people with severe and persistent mental illness who face barriers accessing a psychiatrist.
There are two equally important objectives of the service:
- Provide psychiatry services for those with severe and persistent mental illness who live, study or work within South Western Sydney.
- Support and advice to GPs to build capacity in managing the long-term mental healthcare of these consumers.
What are your service location/s and service hours?
9am to 5pm, Monday to Friday
The service offers flexible delivery including:
- Face-to-face at select general practices in Bankstown, Fairfield, Liverpool and Campbelltown. A list of face-to-face general practices can be found here.
- Telehealth through secure Zoom video conferencing available to any general practice in South Western Sydney or the telehealth hubs in East Hills and Tahmoor.
What is the eligibility criteria to access your service and are there any targeted supports to specific population groups?
Services are available to people aged 12 years and over with a severe and persistent mental illness who need support from a psychiatrist but are unable to access a psychiatrist due to barriers. In addition, the service is available to GPs requiring support in the treatment and management of this cohort.
This service is not designed for Court Reports, NDIS or Disability Support Pension Assessments, RTA Forms or Workers Compensation. Additionally, this service is not for the assessment or treatment of neurodevelopmental or behavioural disorders as a primary reason for referral – such as ADD/ADHD or Autism Spectrum Disorders.
Does your service provide support to people who don’t speak English as a first language?
Yes
If so, what supports are available?
Dokotela utilises the TIS interpreting service. Our preferred method of the interpreting service is face-to-face but in some circumstances the interpreter service is also available via telehealth.
How can people be referred?
Referrals can be made by GPs only. GPs can refer by completing the SWSPHN Mental Health Referral Form and faxing it to 4623 1796 or via the Online Referral Form.
The following information is required, and if not submitted the referral may not be accepted:
- Current medication summary and response to past medications
- Patient medical history
- Patient psychiatric history including past admission discharge summaries or not there has been no admissions
- Correspondence from previous psychiatrists, or note there has been no previous psychiatric assessment
Please provide a case study/example of a client journey when accessing your services, including:
- Why they were referred
- How they were supported
- Who else was engaged and how (eg GP, family etc)?
- What was the outcome
Background
This young man was referred by his GP for ongoing psychotic symptoms despite being on antipsychotic medications. He was reportedly discharged to the care of the GP following two inpatient admissions to a mental health facility at the local teaching hospital.
This young man aged 18 lives with his mother, older brother and younger sister. He is currently single and working in a warehouse in casual employment. He presented for consultation with his mother, who was active in the consultation and assessment process.
Provisional diagnosis and risk assessment
FEP – First Episode Psychosis with a prodrome from high school, with ongoing symptoms despite being on antipsychotic medication for the past six months. No suspected non-adherence, no illicit substance use over the past six months.
Genetic loading of Schizophrenia – paternal aunty
Management plan
Treatment
Increase Aripiprazole to 15mg mane
Continue the Quetiapine for the time being
Investigations
Requested the following investigations be carried out by the GP.
FBC, EUC, LFT’s, TFT’s including Thyroid antibodies, ECG, Vitamin B12 and D, iron studies.
Urine drug screen
Outcome
A detailed assessment/ report was sent to the Early Psychosis Intervention Program (EPIP) psychiatrist after a discussion with the patient and his mother. The patient was discussed with the EPIP psychiatrist at Liverpool Hospital and was accepted into the program. This is a specialised team-based program which provides support to young persons with First Episode Psychosis.
A Day in the life of Dr Samira Bhuiyan
Psychiatrist Specialist with the Consultant Psychiatry Service
Day-to-day role
My day for PHN starts bright and early, usually at the location by 7.30am to get some coffee (give me a few months and I’ll have tried all of the cafes in Western Sydney!). I’m in the clinic by 8am to get set up and review patient files before my first appointment starts. My first patient usually comes in around 9am and they keep coming until 5pm. It’s a pretty busy day until 7pm, especially as I try to get all of the patient notes and reports done before the day ends.
What do you find most challenging about your role?
At the moment the most challenging thing is trying to manage patient expectations while ensuring a good rapport and implementation of a workable management plan. Some patients have waited years or even decades to see a psychiatrist and many have a belief the appointment will ‘fix’ all of their problems.
What you find most rewarding about your role?
Patients are generally grateful to have someone listen to their issues and explain options to them in a collaborative way. It is always nice to see people working to get better. I truly enjoy being able to see the difference good mental health treatment makes on their lives.
What do you enjoy doing outside of your job?
Currently my life is chock full of baby-related events like swimming lessons, grandparent visits and playdates, so there’s little time for much else. In the time I do get for personal activities, I enjoy being able to catch up with friends, being crafty (origami and crochet are my favourites) and going to the movies with my family.