GP mental health treatment plan sample template - Better Access program

Sample template for a GP mental health treatment plan under Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS.

Page last updated: April 2014

Page last reviewed: 15 August 2014

Sample only

PDF version: GP mental health treatment plan sample template (PDF 24 KB)
Word version: GP mental health treatment plan sample template (Word 50 KB)

This sample template allows the following information to be provided:

GP mental health treatment plan

Patient assessment

  • Patient's name
  • Date of birth
  • Address
  • Phone
  • Carer details and/or emergency contact(s)
  • GP name/ practice
  • Other care plan e.g. GPMP/ TCA (yes/no)
  • AHP or nurse currently involved in patient care
  • Medical records no.
  • Presenting issue(s) - what are the patient's current mental health issues
  • Patient history - record relevant biological, psychological and social history including any family history of mental disorders and any relevant substance abuse or physical health problems
  • Medications (attach information if required)
  • Allergies
  • Any other relevant information
  • Results of mental state examination - record after patient has been examined
  • Risks and co-morbidities - note any associated risks and co-morbidities including risks of self harm &/or harm to others
  • Outcome tool used and results
  • Diagnosis

Patient plan

  • List patient needs/ main issues, and for each of these include:
    • Goals - record the mental health goals agreed to by the patient and GP and any actions the patient will need to take
    • Treatments - treatments, actions and support services to achieve patient goals
    • Referrals - note: Referrals to be provided by GP, as required, in up to two groups of six sessions. The need for the second group of sessions to be reviewed after the initial six sessions.
  • Crisis/ relapse - if required, note the arrangements for crisis intervention and/or relapse prevention
  • Appropriate psycho-education provided (yes/no)
  • Plan added to patient's records (yes/no)
  • Copy (or parts) of the plan offered to other providers (yes/no/not required)
  • Completing the plan - on completion of the plan, the GP is to record that s/he has discussed with the patient:
    • the assessment
    • all aspects of the plan and the agreed date for review, and
    • offered a copy of the plan to the patient and/or their carer (if agreed by patient)
  • Date plan completed
  • Review date (initial review 4 weeks to 6 months after completion of plan)
  • Review comments (progress on actions and tasks). Note: If required, a separate form may be used for the review.
  • Outcome tool and results on review

Mental health programs:

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