Engaging the Rural Missing Middle Through GP‑Embedded Mental Health Care
Tracks
Prince
| Thursday, November 5, 2026 |
| 2:00 PM - 2:20 PM |
Overview
Laura Kelly, Medicare Mental Health Centre, Lismore - Open Minds Australia Ltd
Three Key Learnings
1. Embedding mental health clinicians within GP clinics improves early engagement and access for people with psychological distress who may not otherwise seek or reach specialist services.
2. GP‑embedded, brief therapeutic interventions can deliver meaningful improvements in psychological distress while fostering strong therapeutic relationships and emotional safety within familiar primary care settings.
3. Accessible, community‑based support navigation and continuity of care for the rural “missing middle,” including individuals who have never previously accessed mental health support.
Presenter
Laura Kelly
Clinical Lead Projects - Psychologist
Medicare Mental Health Centre, Lismore - Open Minds Australia Ltd
Engaging the Rural Missing Middle Through GP‑Embedded Mental Health Care
Presentation Overview
General Practitioners (GPs) remain a primary access point for people experiencing mental health difficulties, with psychological concerns consistently reported among the most common presentations in general practice. Demand is particularly pronounced in regional settings, where service availability and affordability barriers contribute to a large cohort of people with moderate to severe mental health needs who do not meet thresholds for specialised mental health care — the “missing middle”.
In response, the Lismore Medicare Mental Health Centre (MMHC) implemented a service model integrating mental health clinicians within GP clinics. The initiative aims to strengthen stepped‑care pathways, reduce stigma, and improve navigation and continuity of care for people presenting with emerging mental health symptoms, situational stress, comorbid physical and psychological concerns, hopelessness, or suicidal ideation. Eligible clients are offered up to six onsite sessions of Focused Acceptance and Commitment Therapy (FACT) delivered within the GP clinic.
The program currently operates across three regional GP clinics and has supported over 150 clients. Of the 112 clients who were exited from the service, the majority (59%, n=66) have completed all brief intervention sessions. Among a sub‑sample with outcome data, 56.8% demonstrated statistically significant improvement in K‑10 psychological distress scores. Importantly, 41% of clients had not previously accessed any mental health care.
Qualitative feedback highlighted strong therapeutic relationships, emotional safety, and early symptom relief, with clients reporting feeling supported and heard within a familiar primary care environment. Accessibility, rapid access during periods of need, and the delivery of practical, skills‑based interventions were seen as critical in supporting early intervention and preventing escalation.
This GP‑embedded model demonstrates how integrated, primary‑care‑embedded care can effectively engage the rural “missing middle” and provide timely, navigable mental health support.
In response, the Lismore Medicare Mental Health Centre (MMHC) implemented a service model integrating mental health clinicians within GP clinics. The initiative aims to strengthen stepped‑care pathways, reduce stigma, and improve navigation and continuity of care for people presenting with emerging mental health symptoms, situational stress, comorbid physical and psychological concerns, hopelessness, or suicidal ideation. Eligible clients are offered up to six onsite sessions of Focused Acceptance and Commitment Therapy (FACT) delivered within the GP clinic.
The program currently operates across three regional GP clinics and has supported over 150 clients. Of the 112 clients who were exited from the service, the majority (59%, n=66) have completed all brief intervention sessions. Among a sub‑sample with outcome data, 56.8% demonstrated statistically significant improvement in K‑10 psychological distress scores. Importantly, 41% of clients had not previously accessed any mental health care.
Qualitative feedback highlighted strong therapeutic relationships, emotional safety, and early symptom relief, with clients reporting feeling supported and heard within a familiar primary care environment. Accessibility, rapid access during periods of need, and the delivery of practical, skills‑based interventions were seen as critical in supporting early intervention and preventing escalation.
This GP‑embedded model demonstrates how integrated, primary‑care‑embedded care can effectively engage the rural “missing middle” and provide timely, navigable mental health support.
Biography
A Psychologist and Clinical Lead of Projects at Medicare Mental Health in Lismore NSW, Laura has a keen interest in working with clients from diverse cultural backgrounds and high risk, complex presentations. Laura completed her Masters in Professional Psychology in 2024 at The University of New England. Laura takes a person-centred strengths-based and trauma informed approach to her work, with a strong belief in the importance of creating a safe, supportive and professional therapeutic relationship between client and clinician. Her therapeutic approach is warm, respectful, and grounded in contemporary psychological frameworks, drawing on a wide range of evidence-based interventions.
