The joy of being a headspace GP

Parenting is often challenging - particularly for us as mental health-interested GPs - as we know full well how important it is to get it right with attachment. Thank goodness for Winnicott’s “good enough mother” idea to get us through those sleepless nights!

If you need help, please call

  • Lifeline- 13 11 14
  • BeyondBlue - 1300 22 4636
  • Suicide Call Back Service - 1300 659 467
Suicide Call Back Service Online Chat

Parenting is often challenging - particularly for us as mental health-interested GPs - as we know full well how important it is to get it right with attachment. Thank goodness for Winnicott’s “good enough mother” idea to get us through those sleepless nights! 

Latency (thanks Erikson) gives us a few years of relief when things go underground, and then issues burst out again in adolescence where we get a chance to pick off the scab and have another go.

We know that early intervention is key to successful passage through adolescence. Do you know about “A second chance in the second decade”? It’s a comprehensive report from the World Health Organisation looking at adolescent health and wellbeing and underlining the need for action at every level to improve the health of this vulnerable cohort.

Working with adolescents

You certainly don’t have to be cool or speak the current lingo to work effectively with young people at headspace or anywhere else for that matter (thankfully), but it helps if you are interested in, and passionate about what makes this period of life so special.

Young people often wander into primary care very tentatively - putting them at ease, opening a conversation about wellbeing and offering support can be one of the greatest gifts you can give someone. The chance to feel cared for and to know that the system is on their side can be a life saver.

When my son was a snarly disaffected youth, he’d often ask me when we caught up at the end of the day “Did you save any lives today mum?” –Tuesday at headspace I could sometimes answer yes!

Working at headspace

So what does a day at headspace look like? For me these days it’s full of challenges. When I started the general practice at headspace in Bondi 4 years ago, I was there 4 hours a week and flat chat with patients. Now, with the unwavering support of my wonderful colleagues (from the practice manager, clinical lead, centre manager right up to clinical director, PHN and the board of directors), we have 40 hours of GP coverage per week.

I supervise a registrar and act as “GP clinical lead” ensuring the other 40 odd clinicians understand the breadth and depth of skills we have as GPs. I help to enhance the management of complexity in the service. Yes, it’s supposed to be a service for people with “mild to moderate” conditions but we know that headspace attracts young people of varied levels of morbidity and we do our best to find them all care. GPs are really well placed to “hold” young people waiting for therapy, liaise with other services and specialists, see someone until we work out what’s really going on, help determine stepped care and collaborate with colleagues when young people have complex multi-morbidity.

Where is the joy?

Who are some of my most interesting young people? It’s hard to say. It’s always satisfying to see someone successfully tackle an eating disorder - like the young woman who about 18 months after I’d started seeing her admitted her veganism was in truth a front for her disorder, or a medical student with anorexia who got better really quickly once well supported by a multidisciplinary team and who was able to jump in to her next clinical attachment feeling enthused about the role of GPs.

I love it when young people send their friends or siblings in because they feel listened to and cared for and I like being on the spot to help out colleagues - helping a terrified psychologist manage panic attacks in one of her patients and winning a friend for life!

Teaching at headspace is always fun – there are registrars who are passionate and stay on when fellowed, and medical students who can go back to the hospital able to do a good HEADS assessment.

I also find myself advocating for role of GPs in youth mental health at local and national level and I advocate for good communication with other GPs in the community - running CPD events and connecting professionals.

Is it the same everywhere at Headspace?

You need to know that every headspace is different - I went to the national conference last year convinced my local headspace centre was the best and most innovative. I was so delighted to see a room filled with posters from maybe 50 other centres which were all responding to local needs and had their own unique identities.

There are over 100 headspace centres nationally now and each one could do with more GPs.

There are different models of remuneration ranging from salaried to 100% bulk billings to mixed. They are different in terms of type of practice - sitting alone in a consulting room to even GPs running the place, integrated into the team or busy and communicating only as needed. If you’re interested in this kind of work, please contact me and I’d be happy to link you with the appropriate people.

Karen Spielman karenspi@optusnet.com.au  

And don’t forget to check out the e-headspace website for a range of adolescent friendly online resources https://headspace.org.au/eheadspace/

{{commentCount}} comment(s). You must be logged in and AHPRA verified to view and comment. Login here.

Dr Karen Spielman

I have been a GP in private practice in Inner City Sydney for over 20 years, where my specialist interests are complex chronic medical conditions, mental health, eating disorders and young people.

I have always combined my practice with work with young people in varied settings including youth centres, prison, and hospital and have worked with PHN/Medicare Local/Divisions of GP and GP registrars and medical students. Most recently I have been involved in establishing and expanding the General Practice at headspace Bondi Junction where I benefit from a passionate multi disciplinary team of colleagues.

The latest healthcare news from medcast

Aging Well – a personal perspective
Aging Well – a personal perspective

At 65 and a half (yes, it’s come to that. I’m actually counting the months again!) I find myself reluctantly looking down the barrel of a shotgun labelled “old age”.  It’s OK, don’t panic – I’m not unwell. It’s just that my body hurts and people k...

The CHIME GP study
The CHIME GP study

looking at rational prescribing and test ordering in general practice to improve

Muuuum, I’m bored!!!!
Muuuum, I’m bored!!!!

Has anyone heard that or a variation of it recently? I’ll bet you have! Many years ago, before I had kids of my own, I used to hear my brother-in-law saying to his bored and whining kids “Come on then, I’ll give you a job. I’ve got plenty for y...

What’s your COVID number? A simple way to keep everyone safe and comfortable
What’s your COVID number? A simple way to keep everyone safe and comfortable

A friend mentioned a really great way for managing this which I have been using and sharing with others. As people are going to have different comfort levels when it comes to spending time together, she told me about sharing her COVID social comfo...

Being Well in Difficult Times - Talah
Being Well in Difficult Times - Talah

It’s always helpful to hear how other people cope.  Over the next few weeks we are dedicating the Being Well blog to a series called Being Well in Difficult Times.  In this blog post we speak to Talah - a a Gumbaynggirr/Yaegl young person who shar...

We’re listening at last to Aboriginal and Torres Strait Islander Voices in Mental Health
We’re listening at last to Aboriginal and Torres Strait Islander Voices in Mental Health

Whilst significant progress has been made in incorporating these voices generally, there is a call for diversity in these Lived Experience voices, namely Aboriginal and Torres Strait Islander Lived Experience.

Being Well in Difficult Times- Zoe
Being Well in Difficult Times- Zoe

Zoe is a registered nurse working in theatres. She has elderly parents and a young son. How is she staying so positive in the face of CoVID-19?

Eating Disorders in Adults: Assessment & Treatment Options
Eating Disorders in Adults: Assessment & Treatment Options

Eating disorders, broadly defined by disturbances in eating behaviour and distress centred on food, eating, and body image, affect nearly one million Australians. This blog covers the assessment and treatment options for various conditions.

Being Well in Difficult Times - Gordon
Being Well in Difficult Times - Gordon

Gordon* is a thirty something rural proceduralist GP. Gordon contributed to the national guidelines for the management of COVID-19. Would being in his shoes change your thinking about the pandemic?

Being Well in Difficult Times - Sally
Being Well in Difficult Times - Sally

Sally* is the director of new urban private practice. She is a generalist psychologist & qualified teacher in her mid-forties with two ‘tween girls, and vulnerable (but fit) parents. Her clients include young children, teenagers, university studen...

Being Well in Difficult Times - Margot
Being Well in Difficult Times - Margot

It’s always helpful to hear how other people cope with life's challenges. Over the next few weeks we are dedicating the Being Well blog to a series called Being Well in Difficult Times. We've asked a range of health professionals 3 big questions t...

Being Well in Difficult Times- Elizabeth
Being Well in Difficult Times- Elizabeth

How would you feel if you were pregnant right now? It would probably add a whole other dimension to your concern. What if, to add to the puzzle, your work made you responsible for the mental health of others? Elizabeth* is a thirty-something s...

Being Well in Difficult Times - Dr Vered Gordon
Being Well in Difficult Times - Dr Vered Gordon

Dr Vered Gordon is a GP in Sydney’s Northern Beaches with a special interest in perinatal mental health. For more than a decade Vered developed Black Dog Institute’s highly regarded Professional Education workshops.

Being Well in Difficult Times- Michael Kidd
Being Well in Difficult Times- Michael Kidd

It’s always helpful to hear how other people cope with life's challenges. Over the next few weeks we are dedicating the Being Well blog to a series called Being Well in Difficult Times. Michael's CoVID-19 job responsibilities are huge and his...

Communication in the time of COVID-19
Communication in the time of COVID-19

The COVID-19 pandemic has led to a massive, and almost overnight, transformation in Australian general practice, most notably with the rapid rise in telehealth. What does effective communication via telehealth look like?

KISS - COVID-19 Primary Care Assessment & Management
KISS - COVID-19 Primary Care Assessment & Management

This Keep It Simple Summary (KISS) covers the treatment and management of COVID-19 in the Primary Care environment. Stages of the disease will be explained, followed by a succinct summary risk factors, symptoms, complications, treatment, respirato...

Reframing Isolation
Reframing Isolation

I keep wondering about what we can learn from all these people who live in isolation or confinement. What strategies were put in place and what might the long-term impact of their isolation have been?

Non-drug Approaches to Chronic Pain Management
Non-drug Approaches to Chronic Pain Management

Living with chronic pain is a complex health issue that affects over 3.2 million Australians, with close to 68% of those affected being of working age. As we know, chronic pain can have significant implications on daily functions and quality of l...

Telehealth: How does it work In Practice
Telehealth: How does it work In Practice

We are all starting to do telehealth in the current climate to protect us, our staff and our patients. Many of us feel slightly out of our depth. Here are some quick tips to help you in your practice.

COVID-19 and Us
COVID-19 and Us

Have you thought about what these measures are going to mean for you personally? Even if we avoid the need for self-isolation, we will all need to practice social distancing for possibly 6-12 months until we can all be vaccinated, or until we have...

Join Medcast. It's free and you'll get instant access to essential healthcare news, research and more.

Already a member? Sign-in