Carers identified?

6.4.1 Primary care: general practitioner (GP) practices

Page last updated: 2010

The primary focus of these policies and protocols is identification of carers of people with a mental illness. However information obtained from the literature search and the consultations highlighted the clear role that GPs play in the initial identification of all carers, including those who care for a person with a mental illness. Including mental health within a framework of general health, may also be less stigmatising, thus potentially leading to earlier engagement.

Waiting rooms provide ideal locations for posters and pamphlets that assist people to self identify and to take responsibility for seeking further information. The information should be presented in the most appropriate format for the target audience. In Indigenous pictorial representations of the information has had some success. In other areas electronic communication may be the best medium.

The following content is suggested for a poster appropriate for display in general practice settings that would:

  • Assist people to identify they are a carer;
  • Acknowledge they are entitled to recognition and support;
  • Provide a simple avenue through the free post or internet option to seek further information and support; and
  • Provide opportunities for discussion with the GP practice.
Because these posters are not specific to mental health they avoid the stigma that some people who care for a person with a mental illness can feel. Top of page

Posters such as these could also be suitable for use in settings such as Centrelink offices, Emergency Departments, schools, libraries etc. The content could also form the basis for media ads. See example poster.

Tear off forms could be attached to the posters such as illustrated below (example poster with tear off form) that would enable requests for additional information or contact to be sent via a free post option to the local office of Carers Australia who are well placed to receive and respond to enquiries. Opportunities also exist for GP practice staff to be specific points of contact for people who identify through this mechanism.

The Fourth National Mental Health Plan, 2009 states:

Primary care plays a central role in the treatment and care of those experiencing mental health problems and mental illness. General Practitioners (GPs) are often the first point of entry to the care system. GPs are the route of access to psychologists and other appropriately trained professionals providing services through the Better Outcomes in Mental Health Care and Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule initiatives and the Mental Health Nurse Incentive Program. Their training, attitudes and knowledge of the service system positively influence peoples' experiences of care and treatment outcomes.

GPs are particularly well placed to identify carers. Families concerned about the early warning signs and symptoms of mental health problems or mental illness are likely to see their GP as the first point of contact for information and assistance with a family member. This provides an ideal opportunity for early intervention and better support for carers.

Minimal modification of the Australian Government Initiatives to include carer identification could provide a significant impetus to identification within the primary care sector.

6.4.1.1 Examples of activities that could be used in general practice
6.4.1.2 Referral to specialist MH care
6.4.1.3 Incentives
6.4.1.4 Suggested national protocols for identification of carers in primary care settings Top of page

Example poster for illustrative purposes only

Taken from the Princess Royal Trust UK. More targeted posters could also be developed for use in specialist mental health settings.
Text equivalent below for Example poster
Top of page

Text version of example poster

The example poster provides space for a logo in the top left hand corner. The text on the poster is as follows:

Do you provide support or assistance to someone who lives with
  • mental illness
  • substance abuse
  • physical illness, or
  • a disability
This means that you are a 'carer'.

It also means that you may be entitled to help and support.

Free information packs are available from this service. Complete the attached form and free post to Carers Australia.

Information can also be obtained from Carers Australia Top of page

Example poster with tear off form


Text equivalent below for example poster with tear off form
Top of page

Text version of example poster with tear off form

The poster contains the following text:

Do you provide support or assistance to someone who lives with
  • mental illness
  • substance abuse
  • physical illness, or
  • a disability
This means that you are a 'carer'.

It also means that you may be entitled to help and support.

For a free information pack explaining what help is available please fill in this form, fold along the dotted line, moisten along gummed edge, press edges together and free post today.

The tear off form underneath the text contains the following (and has dashed guide lines showing user where to fold and where to moisten along the gummed edge):

Your name:
Your address:
Postcode:
Tel No:

Being a carer can affect your health. This is why it is a good idea to let your GP practice know that you are a carer too. If you would like us to provide you with additional information or support, please tick the box below and sign.

Please send me information on support services that may be available (tick box)

Would you like us to contact you to discuss your needs (tick box) Top of page

6.4.1.1 Examples of activities that could be used in general practice

(i) The practice notice board

Each practice could ensure that it displays in its general waiting/reception area at least:
  • one prominent poster that:
    • asks adults to identify themselves as a Carer; and
    • offers information on the support available.
  • one prominent poster that:
    • asks adult patients who have a young person helping them at home to identify themselves; and
    • offers information on the support available.
Those surgeries with an electronic means of sharing information with patients in waiting areas could run a routine message that assists people to self identify as carers, the support available and who to contact in the practice. Consideration could be given to presentation of this information in pictorial form in Indigenous Medical Centres.

(ii) Carer registration vouchers

Each practice could ensure that it has Carer Registration 'Vouchers' available to the general public in its waiting/reception areas. These vouchers could be developed on a national basis and obtained from the Divisions of General Practice at no charge. 'Patients who are carers' reading these vouchers could then be directed to complete a voucher and return it to the receptionist at their GP practice so as to receive a Carers Information Pack. They could also be offered a free 'well carer health check' at a time convenient to all parties. The Medicare Benefits Schedule reforms aimed at increasing the uptake in general practice of prevention item numbers due for implementation on 1 May 2010 could be modified to encompass identified carers. The practice could also be responsible for forwarding details for information packs to the appropriate Carers Australia Office. Top of page

(iii) Practice leaflet and new patient registration form

Each practice could ensure that there are relevant questions in Practice Leaflet and New Patient Registration Forms that would lead people to self identify as having a role in caring for someone else, or having someone who provides care to them. The documents should be worded in a manner so as to ensure it attracts the maximum number of 'patients who are carers' as is possible.

This could also be reinforced via the inclusion of a field in the demographic area of the electronic record system for identification of people who are providing care to another person. This will require changes to Zedmed, the clinical software currently used by GPs.

(iv) Consultations and home visits

All consultations provide an opportunity for the GP/Practice Nurse to enquire as to whether or not the person they are seeing as the patient is (as well as being unwell) caring for somebody or being cared for by somebody. Consultations should also be used to establish whether there are children within the family taking an active caring role for a sick or disabled parent or sibling. Top of page

(v) Existing records and other known information

Many receptionists, nurses, practice managers and GPs will already be aware of adult and child 'patients who are carers', or patients who have a carer. This information should not be wasted. Each practice could set aside dedicated time when all staff are asked to prepare a list of all patients known to them that are either 'patients who are carers' or patients who have a carer. Those patients identified as 'patients who are carers', could be sent a Carers Registration Voucher inviting them to apply for Carers Information Packs and, a FREE 'well carer health check'. Those patients identified as having a carer should also be sent a Carers Registration Voucher with a covering letter asking them to pass the voucher to their carer. The practice could be responsible for providing the packs or forwarding details for information packs to the local Carers Australia office.

(vi) Medicare cheques for doctors and prescription folders

Medicare Australia could assist with the identification of carers via the placement of messages on all benefit cheques issued that need to be paid to GPs. These messages could encourage people to speak with their GP if they provide care or support to another person.

This could occur in association with National Carers Week.

Each practice could also ensure that it works on a regular basis with local pharmacies to encourage carers to identify themselves to their GP practice by placing stickers on the folders that are used for repeat prescriptions. Stickers could be developed nationally and obtained free of charge from Divisions of GPs.

This could also coincide with National Carers Week celebrated annually in Australia.

(vii) Influenza vaccination and screening programmes

Regular influenza vaccination, mammogram and other routine screening programs could also provide opportunities for identification of carers through a short list of appropriately worded questions. Top of page

6.4.1.2 Referral to specialist MH care

With consumer and carer consent, the referral letter to specialist mental heath care could identify carers and the role they play in caring for the person with a mental illness. This could also include contact details and a request for continued involvement by the mental health service with the identified carers. This would be facilitated by the addition of a 'carer' field to referral letter templates in GP electronic data bases.

6.4.1.3 Incentives

The RACGP is currently reviewing practice standards. A submission has been made by the Private Mental Health Consumer Carer Network (Australia) for this review to examine mechanisms to ensure revised standards include the identification and support of carers.

Negotiations could also occur with accreditation bodies to have them consider the allocation of accreditation points to practices that demonstrate they have implemented 'carer friendly practices'.

These activities could be further supported by planned changes outlined in the Fourth National Mental Health Plan (2009-2014) for partnerships with other government areas of responsibility.

The Peer Support and Mentoring Programs funded by the Australian Government through FaHCSIA already appear to be identifying carers as key to providing comprehensive services for people with mental illness. Top of page

6.4.1.4 Suggested national protocols for identification of carers in primary care settings


It is recommended that:
  1. The following protocols to identify carers are discussed with the Royal Australian College of General Practitioners for consideration during the 2010 review of the Standards.
    • Provision of general information encouraging self–identification on electronic and paper notice boards including posters and leaflets.
    • New Patient Forms to identify carers.
    • Utilise normal practice appointment consultations.
    • Practice newsletters to feature articles regarding carers.
    • Utilise patients' personal health checks to identify if they undertake care for another person.
    • Have a named member of staff responsible for maintaining the practice's procedure for identification of carers – a carer specialist or champion.
  2. Medicare Australia is asked to consider the placement of messages to assist with the identification of carers on benefit cheques issued during Carers Week held annually in Australia.
  3. Pharmacists are asked to consider the placement of messages to assist with the identification of carers on all folders containing repeat prescriptions during Carers Week held annually in Australia.