September 5, 2025

How to have a mental health conversation with a patient

15 practical strategies GPs can use to support patient mental health in a general practice setting

Why effective mental health conversations with patients matter

GPs are often the first point of contact for patients experiencing mental health concerns. As a GP, these conversations can feel daunting – concerns about time pressures, and uncertainty about how to raise sensitive topics are common. Yet, handled well, a mental health conversation can validate your patient’s experience, reduce stigma, and connect them with the right support.

A lot of the time, the fear boils down to a difference in approach: general medicine focuses on treating diseases by targeting biological symptoms and underlying physical conditions, while psychology necessitates a broader biopsychosocial approach, understanding biological, mental, and social influences to understand and support the individual as a whole.

From a patient’s perspective, it’s not always an easy conversation, either. Patients may fear being judged, worry about confidentiality, or simply struggle to find the right words to describe phenomena that are often ambiguous and intangible.

At Sonder, we’ve been delivering mental health services across South Australia for over 30 years. Drawing on the expertise of our clinical team, we’ve pulled together 15 practical and evidence-based tips to support GPs and other health professionals in having meaningful and constructive mental health conversations.

How to have an effective mental health conversation with a patient

1. Build your own skills first

Before having mental health conversations with a patient, one of the most important things a GP can do is undertake Mental Health Skills Training. This training helps GPs understand presentations more deeply, ask better questions, and engage in a way that makes patients feel heard.

While Mental Health Skills Training is not mandatory for all GPs in Australia, it’s strongly recommended by industry bodies. It also grants GPs access to higher-fee Medicare items (MBS 2715 and 2717) for mental health care.

There are two levels of training, and many GPs report that even completing Level 1 dramatically increases their confidence and quality of mental health conversations.

Resource: Explore options via the General Practice Mental Health Standards Collaboration’s website Mental Health Skills Training options.

2. Set the tone early

Patients often take cues from their GP about what is “appropriate” to bring up. Incorporating open-ended questions can set the tone for an honest conversation. Examples include:

“How have you been feeling within yourself lately?”
“What, if any, changes have you noticed in your mood, energy, or sleep?”
“What’s been most stressful for you recently?”

Framing these questions as routine helps normalise the idea that mental health is part of a standard consultation. There is no need to wait until an issue arises: asking these questions in every check-up can help you identify issues before they escalate.

3. Create a space of safety

Your presence, tone, and body language influence how much a patient may share.

To create a space of safety:

Be present and attentive: face your patient when speaking, minimise distractions, and make sure your body language shows that you’re listening.
Approach questions with open curiosity rather than assumptions. Try questions like:
- “Do you feel safe to explore this with me right now?”
- “If we unpack this today, do you have support or a plan to keep yourself safe when you get home?”
- “What would help you feel safe to continue this conversation?”

4. Acknowledge your biases

Every clinician carries biases – conscious or unconscious. The goal is not to eliminate them, but to recognise, reflect on, and manage them so they do not compromise patient care.

In mental health consultations, common biases may include:

Diagnostic biases: attributing all symptoms to a known mental health condition (e.g. dismissing chest pain as “just anxiety” when physical causes still need investigation).
Stigma-related biases: assuming that people with conditions such as schizophrenia or borderline personality disorder are “difficult” or “non-compliant”.
Cultural biases: expecting all patients to describe or experience mental health conditions in the same way. For example, Aboriginal and/or Torres Strait Islander people may talk about a disconnection from Country, rather than using terms like “depression”.
Gender biases: minimising or dismissing symptoms – for instance, labelling women’s concerns as “dramatic”.
Socioeconomic status: attributing symptoms to lifestyle choices without acknowledging systemic and structural barriers.

To identify and manage your biases, try these strategies:

Pause and reflect: If you notice frustration or judgement arising, ask yourself whether these feelings are linked to the patient – or to assumptions you may be making.
Seek the patient’s perspective: Before framing something in clinical terms, invite the patient to explain how they understand their own experiences.
Explore context: Encourage patients to share cultural, social, or personal factors to further your own understanding.
Consult with peers: Discussing biases and blind spots openly with trusted colleagues helps build self-awareness and strengthens practice over time.

5. Use recovery-oriented language

The words you use shape how patients feel about their diagnosis and treatment. Recovery-orientated language communications collaboration, empowerment, and respect. It reinforces that recovery is possible, rather than framing the patient by their illness.

To reflect on whether your language support recovery, consider asking yourself:

Am I conveying hope? Do my word suggest optimism and belief in the patient’s ability to improve?
Am I showing commitment? Do I sound engaged and invested, or detached and uninterested?
Am I reinforcing agency? Am I encouraging the patient to take an active role in their care, rather than positioning them as passive?

Resource: For further guidance, the Mental Health Coordinating Council’s Guide to Recovery-Oriented Language provides practical examples.

6. Use person-centred language

In the context of a conversation about mental health, using person-centred language means separating the individual from their diagnosis and recognising them as more than a condition. This approach respects the person’s identity, affirms their lived experience, and promotes shared decision-making.

For example:

Instead of: “You are schizophrenic.”
Try: “You’re experiencing a mental health condition called schizophrenia. This looks different for everyone – what has your experience been like?”

This phrasing acknowledges the diagnosis without defining the patient by it. It also positions the patient as the expert in their own life, which encourages shared decision-making and treatment buy-in.

Resource: For more practical tools, download the Person-Centered Language Practice Tool PDF from the Center for Practice transformation.

7. Normalise and de-stigmatise

Many patients carry self-stigma about their mental health. This can erode self-esteem, prevent help-seeking, and worsen symptoms.

During consults, using statements like, “many people experience anxiety or low mood, it’s very common and treatable” can go a long way towards reducing shame.

Sharing prevalence data can also help patients understand that their experience is not unusual. According to the 2020–2022 National Study of Mental Health and Wellbeing:

1 in 5 Australians aged 16–85 (22%, or 4.3 million) experienced a mental disorder.
17% of Australians experienced an anxiety disorder.
1 in 7 children and adolescents aged 4–17 years experienced a mental illness.
5 million Australians experienced an affective disorder.

8. Make longer appointments to understand the full story

A standard 10-15 minute consultation is often insufficient for exploring mental health concerns. If a patient raises a psychological concern during a short consult, acknowledge their concerns and suggest a longer follow-up appointment.

This approach benefits both patient and GP. For the patient, it communicates that their concerns are taken seriously and provides a space where they won’t feel rushed. For the GP, it reduces the pressure of managing complex issues in limited time and allows for a more structured, thoughtful response.

Some mental health conditions, like depression and anxiety, can be caused or exacerbated by circumstance. Longer consultations allow you to gather more context and ask about social factors (work, relationships, finances) to paint a fuller picture of potential causes.

Useful prompts include:

“How are things going at work?”
“What’s been happening in your relationship/marriage?”
“Do finances or employment uncertainty play a role here?”

Taking the time to gather context reduces the risk of defaulting to medication as the first or only intervention. Instead, it enable you to identify underlying causes, and gather enough information to link patients with the most appropriate supports.

9. Involve family or a support person – with consent

With the patient’s consent, involving a family member or support person can add significant value. Having a loved one present in a follow-up consultation may:

Help them better understand the patient’s condition.
Provide strategies to offer meaningful support at home.
Reduce the patient’s sense of isolation by reinforcing that they are not facing challenges alone

This approach will not be suitable for everyone. Where appropriate, including a support person can ease isolation and create a more supportive environment outside the clinic, it’s worth exploring.

10. Screen sensitively

Screening tools such as the Kessler Psychological Distress Scale-10 (K-10), Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7 (GAD-7) can be valuable in guiding assessment. However, the way these tools are introduced to your patients can make a significant difference to how comfortable they feel completing them.

Avoid technical or jargon-heavy explanations. Instead of saying:

“This yields a global measure of distress based on your answers to questions about anxiety and depressive symptoms”.

Try framing it more simply:

“This questionnaire helps me understand how your mood has been affecting you over the past couple of weeks.”

11. Don’t be afraid to ask about risk

Some patients may experience thoughts of harming themselves or others. This can be a challenging area for GPs – there can be fears about saying the wrong thing, upsetting the patient, or not knowing what to do if they answer “yes.”

Avoiding the question, however, does not remove the risk. In fact, it may close off a critical opportunity to intervene early. A direct and compassionate approach can open the door to an honest conversation. For example: “Sometimes, when people feel this low, they think about harming themselves. Has that been happening for you?”

Framing the question this way normalises the experience and reduces stigma, making it easier for the patient to respond.

Asking about risk allows you to:

Identify concerns early and work with the patient on a safety plan.
Offer hope of recovery by using person-centered and recovery-oriented language.
Link to supports such as after-hour services if needed.

If a patient denies having suicidal thoughts but you remain concerned (perhaps due to clinical presentation, history, or risk factors), gently revisit the topic later in the consultation, or during a follow-up. Documentation of your concerns, rationale, and any steps taken is also vital.

Resource: download the General Practice Mental Health Standard Collaboration’s suicide prevention and first aid resource. Lifeline also offer a free online toolkit to support people experiencing intrusive thoughts.

12. Explore strengths and supports

Strengths-based practice involves using positive and empowering language to highlight strengths and possibilities. In your consultation, this might look like balancing a problem-focused discussion with questions about what’s helping. You might ask:

“What helps you cope when things are tough?”
“Who can you lean on?”
“What’s something you’ve managed well despite the stress?”

Highlighting strengths encourages patients to see themselves as capable, which can counterbalance feelings of hopelessness.

13. Empower, don’t impose

Patients are more likely to engage in supports when they have a voice in shaping their recovery. Rather than issuing a checklist of tasks, take a more collaborative approach. Using phrases such as:

“I want to empower you to take the next steps in your recovery”
“Do you feel ready to make your own decisions, or would you like support – and in what way?”

Next steps might include:

Brief interventions.
Completion of a Mental Health Treatment Plan and referral to a psychologist.
Specialist referrals (psychiatry, community mental health).
Lifestyle, peer, or social programs.

As some mental health conditions can make individuals feel overwhelmed or have difficulty with remembering details, it’s helpful to summarise key points on what you discussed, agreed next steps, and where to go for support.

14. Seek clinical supervision

Unlike psychologists and social workers, most GPs in Australia do not routinely access clinical supervision post-training. However, having a trusted colleague or mentor to discuss complex cases with is invaluable.

Options include paid supervision through organisations such as General Practice Supervision Australia.

Supervision strengthens clinical practice, supports decision-making, and safe-guards your own wellbeing.

15. Look after yourself!

Supporting patients who are experiencing trauma or distress can be emotionally taxing. Vicarious trauma builds over time, sometimes without being noticed until it begins to affect your own wellbeing.

Make time to debrief, seek peer support, and access supervision where available. Remember: looking after your own mental health is essential to providing sustainable care.

Resource: visit the 1800 Respect website to learn more about work-induced stress and vicarious trauma.

In summary

A mental health conversation doesn’t need to be perfect to be impactful. What patients often remember most is that their GP listened without judgement. By creating a space of safety, using recovery- and person-oriented language, involving supports where appropriate, and continuing your own professional development, you can make mental health consultations safe, validating, and effective for patients experiencing mental health challenges.

For urgent or life-threatening presentations, call 000 immediately.

For more information about Sonder’s mental health services, visit sonder.net.au/mental-health or email info@sonder.net.au. We also provide two walk-in mental health services in northern Adelaide: Northern Adelaide Medicare Mental Health Centre and Safe Haven.