GP Burnout and Mental Health: A Guide to Self-Referral and Peer Support in Western Australia

General practice has always been demanding, but in recent years it has become clear that something more serious is happening. Burnout among Australian GPs is no longer a marginal concern; it is a systemic crisis.

The RACGP’s Health of the Nation 2023 report found that 71% of practising GPs had experienced feelings of burnout in the previous 12 months, with overall job satisfaction falling to 66%. Subsequent reports show that while job satisfaction has recovered somewhat, high levels of burnout and distress remain entrenched. International research has consistently shown that physician burnout is associated with roughly double the risk of patient safety incidents and other markers of compromised care.

For GPs in Western Australia, the situation is complicated further by professional isolation, rural and remote practice, and the ongoing pressure of providing comprehensive care in a stretched system. This article explores what burnout is, why GPs are particularly vulnerable, and—critically—how GPs in WA can safely access help through self-referral and peer support without sacrificing their professional identity or career.

The Scope of the Problem: Burnout Rates Among Australian GPs

Burnout as an occupational phenomenon

The World Health Organisation classifies burnout as an “occupational phenomenon” in the ICD-11: a condition resulting from chronic workplace stress that has not been successfully managed, rather than a personal weakness or a mental disorder in its own right. It is defined by three key dimensions:

• Feelings of energy depletion or exhaustion

• Increased mental distance from one’s job, or cynicism/negativism about work

• Reduced professional efficacy

In other words, burnout is a problem of context and workload as much as individual vulnerability. For GPs, who sit at the intersection of clinical complexity, emotional labour and administrative pressure, the conditions for burnout are almost perfectly aligned.

Australian data paints a stark picture. The 2023 Health of the Nation report not only identified that 71% of GPs had experienced burnout, but also showed a steady decline in job satisfaction, driven by financial pressure, administrative burden and concerns about practice viability. Later reports show some recovery in satisfaction, but rising dissatisfaction with paperwork, compliance and practice costs. Many GPs say they would not recommend general practice as a career to junior colleagues, and a substantial proportion are considering early retirement or leaving clinical practice altogether.

From a systems perspective, burnout is not just a wellbeing issue; it affects patient safety, continuity of care and the sustainability of the entire primary care workforce.

How burnout looks and feels in general practice

Burnout in GPs rarely appears overnight. It creeps in gradually, often disguised as “just being tired” or “having a rough term.” Over time, many doctors recognise some or all of the following:

• Overwhelming exhaustion: feeling drained before the day begins, relying increasingly on adrenaline and caffeine just to get through sessions, struggling to recover even after a weekend or short break.

• Detachment and cynicism: a subtle shift from empathy to irritation or numbness; viewing patients as “problems to process”; dreading certain appointment types; becoming increasingly negative about the profession, the system or colleagues.

• Reduced sense of efficacy: feeling that nothing you do really makes a difference; doubting your own competence despite years of experience; becoming preoccupied with the fear of making mistakes or missing something important.

This picture often co-exists with symptoms of anxiety, low mood, sleep disturbance, irritability, difficulty concentrating, or increased reliance on alcohol or other substances. Some GPs notice that they are avoiding their own GP, delaying investigations for themselves, or ignoring health issues that they would never allow a patient to neglect.

It is important to emphasise that burnout overlaps substantially with depression and anxiety, and in many cases the conditions co-occur. Left unaddressed, burnout is associated with higher rates of cardiovascular disease, mental health problems and early exit from the profession.

Why GPs are particularly vulnerable

While every health profession is under strain, several features of general practice make GPs especially exposed to burnout.

1. Resource deficits

Most GPs are acutely aware of the gap between what they are expected to provide and the resources they have to work with. Common contributors include:

• Short appointment times with increasingly complex, multimorbid patients

• Inadequate administrative support or practice infrastructure

• Funding models that reward volume over complexity and continuity

• A constant stream of electronic messages, results, e-scripts and forms that spill well beyond the consulting day

RACGP data shows that dissatisfaction with administrative burden has grown markedly in recent years, with around 70% of GPs reporting frustration with the amount of paperwork required.

2. Workload pressure

General practice has long carried the weight of being the “front door” to the health system. For many GPs, this means:

• High patient volumes day after day, with limited control over demand

• After-hours responsibilities, nursing home visits, results checking and paperwork completed in evenings or on weekends

• Constant emotional labour—holding distress, grief and complex risk, often in quick succession

• Increasing compliance tasks and medico-legal anxiety, especially in a climate of scrutiny around prescribing, referrals and billing

International research consistently shows that physicians experiencing burnout have around twice the odds of being involved in patient safety incidents, with reduced professionalism and lower patient satisfaction. This is not about individual doctors becoming reckless; it is about the predictable consequences of pushing highly conscientious professionals beyond sustainable limits.

3. System issues and culture

Many GPs describe feeling simultaneously indispensable and undervalued. Systemic factors that fuel burnout include:

• Unsupportive or fragmented work environments: solo or small practices with limited collegial support, or corporate models that prioritise throughput over quality

• Professional isolation: particularly for rural and remote GPs, or those working in niche areas who lack peers with similar caseloads

• Stigma around seeking help: fears about AHPRA notifications, loss of reputation, or being seen as “not coping” remain significant barriers to doctors seeking mental health care.

In Western Australia, these pressures are compounded by geography. Rural and remote doctors often carry enormous clinical and community responsibility with limited backup, limited locum cover, and fewer local mental health resources.

The net effect is that many GPs only seek help when they are already exhausted, demoralised or in crisis. One of the most powerful protective steps any GP in WA can take is to establish a deliberately structured pathway for their own healthcare—especially mental health care—before reaching that point.

Self-Referral Pathways for GPs and Medical Practitioners

Why every GP needs their own GP

There is a clear consensus across colleges, regulators and doctors’ health organisations: every doctor should have their own GP. Despite this, many GPs still self-diagnose, self-treat and self-prescribe, especially for mental health concerns.

Treating oneself may feel efficient or pragmatic, but it carries significant risks:

• Reduced objectivity and diagnostic accuracy

• Tendency to minimise or rationalise symptoms that would concern you if a patient reported them

• Fragmented care, with no one holding the overall picture of your health

• Increased risk of problematic prescribing patterns

Having your own GP creates psychological and practical permission to step into the patient role. It allows you to talk openly about stress, mood, relationships, substance use, sleep, physical health and career concerns without trying to manage the clinical decision-making at the same time.

In WA, services such as the Doctors’ Health Advisory Service of WA (DHASWA) maintain a “Doctors for Doctors” list of GPs and psychologists who have a special interest in treating doctors and medical students, and who understand the culture and pressures of the profession. This can be an excellent starting point if you are unsure where to begin.

What a GP self-referral pathway looks like in practice

For GPs and other medical practitioners, the most effective way to access mental health support is to establish a formal doctor–patient relationship with another GP, and then follow the same Mental Health Treatment Plan (MHTP) process available to any other patient. The key steps typically look like this, though in practice they often overlap.

1. Choosing a treating GP

Ideally, choose someone outside your immediate practice and outside your close social circle. This supports objectivity, confidentiality and clearer boundaries. Many doctors prefer a GP in a different suburb or region, or someone who does not work closely with their professional colleagues or family.

When you book, it can help to state explicitly that you are a GP seeking care for your own mental health and would like a long appointment. This sets the tone from the outset: you are there as a patient.

2. Comprehensive assessment

In that first consultation, expect to be treated like any other patient. A thorough assessment may cover:

• Current symptoms (e.g., exhaustion, sleep disturbance, anxiety, low mood, irritability, cognitive fog)

• Workplace factors (hours, on-call, administrative load, practice culture, medico-legal stress)

• Personal history (previous mental health difficulties, trauma, substance use, physical health conditions)

• Risk factors (suicidal thoughts, self-harm, reckless behaviour, significant impairment at work)

• Protective factors and supports (family, friends, peer networks, supervision, spiritual or community resources)

It can feel uncomfortable to answer these questions when you are used to being the assessor, but allowing another clinician to hold the clinical frame is itself part of the therapeutic process.

3. Developing a Mental Health Treatment Plan as a GP-patient

If you meet criteria for a mental health condition such as major depression, anxiety disorder, adjustment disorder or PTSD, your treating GP can create a Mental Health Treatment Plan. The plan should be collaborative and specific, rather than a generic template.

A good MHTP for a GP with burnout-related difficulties might include:

• Clear working diagnoses (e.g. major depressive episode with prominent occupational burnout; generalised anxiety disorder; trauma-related symptoms)

• Explicit treatment goals (for example, restoring sustainable workload, re-establishing sleep, reducing alcohol use, improving emotional regulation, addressing perfectionism or unrelenting standards)

• Planned psychological interventions (such as CBT, ACT, trauma-focused therapy, schema work or supportive therapy) with nominated practitioners

• Consideration of medication, exercise, sleep interventions, social connection and workplace adjustments

• A realistic review schedule that acknowledges your workload but does not let months drift by

Under the Better Access initiative, eligible patients can currently access Medicare rebates for up to 10 individual psychological therapy sessions per calendar year, plus group sessions, when referred under a valid MHTP. This applies equally to doctors and non-doctors. Many GPs choose to combine Medicare-subsidised sessions with private-pay sessions if they wish to see a particular clinician more frequently or for longer-term work.

It is important to note that you cannot write your own Mental Health Treatment Plan. The plan must be generated by your treating GP, and any referral letters to psychologists or psychiatrists should come from them.

4. Specialist referrals and ongoing care

Depending on your needs, your GP may refer you to:

• A clinical psychologist or other psychologist with a strong interest in doctors’ health

• A psychiatrist, especially if there are significant risk issues, complex medication questions, or diagnostic uncertainty

• Other supports such as sleep physicians, pain specialists or addiction services

In WA, DHASWA and DRS4DRS can help identify clinicians who are experienced in working with doctor-patients and who prioritise confidentiality and rapid access where possible.

Ongoing care might also include:

• Adjusting work hours, on-call rosters or practice settings

• Planning periods of leave or gradual return to work

• Addressing unhelpful perfectionism, guilt about stepping back, and fears about career damage

• Considering broader career questions, such as portfolio diversification or changes in practice type

The key message is that you are entitled to comprehensive, evidence-based care, not just a quick script for an antidepressant and a vague suggestion to “look after yourself.”

Beyond the MHTP: using doctor-specific services alongside your own GP

While a personal GP is central, several doctor-specific services provide additional layers of support, often at no cost:

• DHASWA (Doctors’ Health Advisory Service of WA) provides a confidential, anonymous 24/7 advice line staffed by experienced GPs and psychologists, offering support and referrals for doctors and medical students in WA.

• DRS4DRS offers a national telecounselling service (1300 374 377) with up to three sessions of confidential counselling for doctors, medical students and their partners, as well as pathways to local care.

• RACGP GP Support Program provides free, confidential counselling for RACGP members through Telus Health, available 24/7 for crisis situations and during business hours for ongoing support.

These services do not replace having your own GP, but they can be crucial in moments of acute distress, during crises, or while you are arranging longer-term care.

Resources and Support Networks in Western Australia

Western Australia has developed a robust network of services specifically designed to support doctors’ mental health and wellbeing. For GPs, understanding the landscape can make it easier to reach out early rather than waiting until things fall apart.

Crisis and acute support

If you are in immediate danger or at risk of harming yourself or others, you should call 000 or attend your nearest emergency department. General crisis lines such as Lifeline (13 11 14) and the Suicide Call Back Service (1300 659 467) are also available 24/7 to all Australians.

Alongside these general services, several clinician-specific lines operate nationally:

• DRS4DRS Telecounselling (1300 374 377) provides 24/7 confidential mental health support for doctors and medical students, with counsellors, psychologists and social workers trained to understand medical culture.

• CRANAplus Bush Support Line (1800 805 391) offers free, confidential 24/7 counselling to rural and remote health workers, including GPs, and their families.

• RACGP GP Support Program (1300 361 008) provides 24/7 crisis counselling for RACGP members, plus scheduled counselling sessions during business hours.

These services can be used when you feel things are “on the edge”—for example, when suicidal thoughts are emerging or escalating, when you feel unable to face another day at work, or when a critical incident has left you shaken and distressed.

WA doctor-specific organisations and supports

Western Australia has some particularly important local supports for GPs:

• Doctors’ Health Advisory Service of WA (DHASWA)
  DHASWA operates a 24/7 confidential and anonymous advice line (08 9321 3098) for doctors and medical students. Calls are taken by experienced GPs and psychologists, and callers are not required to identify themselves. DHASWA is explicitly exempt from the mandatory reporting requirements of the Medical Board of Australia, meaning that clinicians using the service can speak more freely about health concerns, including impairment, without triggering an automatic notification.

DHASWA also maintains a Doctors Access List of GPs and psychologists with an interest in doctors’ health, making it easier to find a treating clinician who understands medical culture and can offer timely appointments.

• DRS4DRS Western Australia
  DRS4DRS links directly with DHASWA in WA, providing a coordinated doorway to local services and national telecounselling, and is funded by the Medical Board but administered at arm’s length from regulators.

• Rural Health West and WA Country Health Service supports
  For rural GPs, additional supports include the Rural Health West family and social support programs, employee assistance programs, and targeted resources for junior medical officers and rural practitioners. Many of these emphasise the importance of having a personal GP, using DHASWA, and accessing counselling early.

Peer support programs and reflective practice

Formal peer support can be a powerful antidote to professional isolation and a protective factor against burnout. Several structures are commonly used:

Balint groups

Balint groups are structured case discussion groups where GPs meet regularly to explore the emotional and relational aspects of clinical work. The focus is not on “solving” the case but on understanding the doctor–patient relationship and the feelings it evokes.

For many GPs, Balint-style groups provide:

• A safe space to talk honestly about frustration, fear, guilt, helplessness or anger

• Normalisation of emotional responses that are often kept hidden

• Greater insight into how their own patterns (perfectionism, rescuing, avoidance) interact with complex cases

Balint groups may be offered through training organisations, hospital networks, private facilitators or informal GP networks. Even if a formal Balint group is not available, similar reflective case discussions can be built into local peer groups.

Mentoring

Mentoring programs—whether through colleges, local health networks or informal arrangements—allow more experienced practitioners to support GPs at earlier stages of their career, or those navigating specific challenges such as practice ownership, rural practice, or late-career transitions.

Good mentoring relationships can help GPs:

• Make sense of systemic pressures without personalising them as failure

• Set realistic boundaries around work, on-call and availability

• Explore career diversification and role redesign

• Feel less alone in their doubts, frustrations and ethical dilemmas

Team debriefing and peer consultation

Critical incidents, patient deaths, complaints, medico-legal scares and near misses can be deeply destabilising. Regular, structured debriefing within practices or peer groups helps prevent clinicians from internalising these events as evidence of personal inadequacy.

In WA, many hospital and health services have access to formal debriefing and employee assistance programs; private practice GPs can emulate this by establishing regular peer meetings with explicit permission to discuss the emotional impact of clinical events, not just the technical aspects.

Confidentiality and mandatory reporting: what WA doctors need to know

Fear of mandatory reporting is one of the biggest barriers to GPs seeking mental health care. Many doctors worry that admitting to suicidal thoughts, substance use, or impairment will automatically lead to an AHPRA notification and possible restrictions on their practice.

The reality is more nuanced, and in Western Australia there are particularly important protections.

• DHASWA is exempt from mandatory reporting requirements. Calls to the service do not trigger mandatory notifications, and clinicians using the service can remain anonymous if they wish.

• Even outside DHASWA, the threshold for mandatory reporting in relation to impairment is high and focuses on substantial risk of harm to the public, not on the mere presence of a mental health condition.

• In WA, treating practitioners have specific protections that allow them to focus on treating doctor-patients rather than acting as de facto regulators, although other clinicians may still have obligations in limited circumstances of notifiable conduct (such as practising while intoxicated, sexual misconduct, or significant departures from professional standards).

This article cannot provide legal advice, and the details of mandatory reporting can be complex. However, it is reasonable to say that seeking help early—before impairment becomes severe—is far safer for both you and your patients than waiting until things are critical. Doctor-specific services such as DHASWA and DRS4DRS have deep experience in guiding doctors through these concerns and can help you understand your options in a confidential setting.

Digital and online resources

Alongside phone and face-to-face services, several online platforms have been developed specifically for health professionals:

• TEN – The Essential Network for Health Professionals, developed by the Black Dog Institute, provides self-assessment tools, psychoeducation and links to supports designed to address burnout and mental health difficulties in clinicians.

• RACGP self-care resources offer practical guidance on maintaining wellbeing, establishing a personal GP, and accessing further support agencies and courses.

These tools can be useful first steps, especially for GPs who are not yet ready to speak to someone directly, but they are best viewed as complements—not substitutes—for genuine clinical care.

Putting it Together: A Practical First Step for GPs in WA

Burnout among GPs is not a sign that the profession has suddenly become populated by “less resilient” doctors. It is an understandable and predictable response to sustained mismatch between workload, resources and expectations in a system under prolonged strain.

For GPs in Western Australia, there are three key messages.

First, your distress is legitimate and treatable. Burnout is an occupational phenomenon, not a personal failing. Feeling exhausted, detached or ineffective does not mean you are a bad doctor; it means you have been working under conditions that would wear down almost anyone.

Second, you are entitled to be a patient. Establishing a relationship with your own GP, allowing yourself to be assessed thoroughly, and using a Mental Health Treatment Plan to access psychological care are not indulgences; they are clinically and ethically appropriate responses to being unwell. You do this every day for others. You are allowed to do it for yourself.

Third, you do not have to face this alone. In WA, services like DHASWA, DRS4DRS, CRANAplus Bush Support and the RACGP GP Support Program exist precisely because the system recognises that doctors are human and that the health of the profession is a public-interest issue. Peer support, Balint groups, mentoring and reflective practice can help restore a sense of connection and shared humanity in a role that can otherwise feel isolating.

If you recognise yourself in this description—if you wake up already dreading your sessions, if you are increasingly numb or irritable with patients, if you are thinking about quitting medicine altogether—it may be time to take a small but decisive step.

That might be as simple as:

• Booking a long consult with a GP you trust and telling them, plainly, “I think I’m burning out.”

• Calling DHASWA on 08 9321 3098 or DRS4DRS on 1300 374 377 to talk through what is happening.

• Asking a colleague whether they would be interested in starting a small peer group to talk honestly about the emotional side of practice.

You would not expect a patient with similar levels of distress to “just push on.” Extending the same standard of care to yourself is not selfish; it is part of practising safely, sustainably and humanely—for your patients, your colleagues, and your own life beyond medicine.