How mental health is examined
The AKT is 150 single-best-answer questions in a four-hour paper sitting. In the 2026.1 sitting, 1,117 candidates sat the exam and 80.6% passed, with a pass mark of 67.1% set by the modified Angoff method. The RACGP notes that questions can have between five and ten options, that more than one option may be plausible, and that you must choose the most appropriate one for the scenario.
Recent reports list major depressive disorder, bipolar disorder, generalised anxiety disorder, eating disorders and self-harm among examined topics.
Assessment tools used in general practice
| Tool | Use |
|---|---|
| K10 | General psychological distress; used in mental health treatment plans |
| PHQ-9 | Depression severity |
| GAD-7 | Anxiety severity |
| EPDS | Perinatal depression |
| AUDIT-C | Alcohol screening |
| HEADSS | Adolescent psychosocial assessment |
Depression and anxiety
- Mild: psychological therapy, activity, sleep and support. Moderate to severe: SSRI plus therapy.
- Review within 1 to 2 weeks of starting an antidepressant; young people need closer monitoring for suicidal thinking.
- Continue an antidepressant for at least 6 to 12 months after remission, then taper slowly.
- Anxiety disorders: CBT first; SSRIs for moderate to severe; avoid long-term benzodiazepines.
Mental health treatment plans and Better Access
A GP mental health treatment plan enables Medicare-subsidised sessions with psychologists and other eligible allied mental health providers under the Better Access initiative, with a review by the GP. Medicare Mental Health Centres and Head to Health provide additional entry points, and headspace serves young people aged 12 to 25.
Session numbers and eligibility under Better Access have changed several times; check current MBS rules.
Bipolar disorder and psychosis
- Screen for previous mania or hypomania before starting an antidepressant.
- Lithium needs regular levels, renal and thyroid monitoring, and advice about dehydration and interacting drugs.
- First-episode psychosis: exclude drugs and organic causes and refer early to youth or adult mental health services.
- Monitor metabolic effects of antipsychotics in general practice.
Self-harm and suicide risk
- Ask directly about suicidal thoughts, plans and means.
- Address immediate safety, involve family with consent, and arrange urgent mental health review when risk is high.
- Prescribe medicines in small quantities when overdose risk is a concern.
- Make a written safety plan and give crisis line details (such as Lifeline 13 11 14).
Eating disorders
- Check weight, BMI, vital signs including postural changes, ECG and electrolytes.
- Admit for medical instability: bradycardia, hypotension, hypothermia, electrolyte disturbance, or rapid weight loss.
- An eating disorder treatment and management plan gives access to Medicare-subsidised psychological and dietetic sessions.
- Watch for refeeding syndrome with low phosphate.
Alcohol and other drugs
- Brief intervention for risky drinking; acamprosate or naltrexone to support abstinence or reduction.
- Thiamine for people with heavy alcohol use and poor nutrition.
- Opioid agonist treatment with buprenorphine or methadone can be provided in general practice with appropriate authority.
- Offer take-home naloxone to people at risk of opioid overdose.
Worked examples
Worked example 1 · Depression
A 34-year-old woman has 6 weeks of low mood, poor sleep and loss of interest. Her PHQ-9 is 17. She has no history of mania and no suicidal thoughts. What is the most appropriate management?
- A Watchful waiting for 3 months
- B An SSRI and psychological therapy under a mental health treatment plan
- C Lithium
- D Diazepam at night
- E Urgent psychiatric admission
Show the reasoning
Answer B. A PHQ-9 of 17 indicates moderately severe depression. Combined SSRI treatment and psychological therapy is recommended, and a mental health treatment plan provides access to subsidised therapy. Review within 1 to 2 weeks.
Worked example 2 · Bipolar screening
A 22-year-old man with low mood mentions a week last year when he barely slept, spent his savings and felt "unstoppable". What is the most appropriate next step?
- A Start sertraline
- B Refer for psychiatric assessment of possible bipolar disorder before starting an antidepressant
- C Start a benzodiazepine
- D Reassure
- E Order a thyroid ultrasound
Show the reasoning
Answer B. The history suggests a previous manic episode. Antidepressant monotherapy can trigger mania in bipolar disorder, so assess for bipolar disorder before choosing treatment.
Common traps
- Starting an antidepressant without asking about mania.
- Prescribing large quantities to someone at risk of overdose.
- Long-term benzodiazepines for anxiety.
- Missing medical instability in eating disorders.
- Forgetting the pathway answer: plans, Better Access and headspace.
Free sample mental health questions
Questions from our GP AKT bank. Choose your answer, then open the explanation.
A woman attends her 6-week postnatal check. Which tool is recommended to screen for perinatal depression?
- AMini-Mental State Examination at 6 weeks
- BGlasgow Coma Scale
- CEdinburgh Postnatal Depression Scale
- DKessler K6 for children
- EAUDIT-C questionnaire
Show answer and explanation
Answer C. The Edinburgh Postnatal Depression Scale (EPDS) is recommended in pregnancy and the postnatal period, with psychosocial assessment. A score of 13 or more suggests depression, and any positive answer to the self-harm item needs immediate assessment.
Learning point: Use the EPDS for perinatal depression screening; act on the self-harm item.
A 35-year-old with moderate depression wants to see a psychologist with a Medicare rebate. What is needed?
- ANo referral; rebates are automatic
- BA psychiatrist referral first, always
- CA hospital admission
- DA GP Mental Health Treatment Plan
- EA private health insurance letter of approval
Show answer and explanation
Answer D. Under the Better Access initiative, a GP prepares a Mental Health Treatment Plan and refers to a psychologist or eligible allied health professional for Medicare-subsidised sessions, with review after the initial block of sessions.
Learning point: Better Access: GP Mental Health Treatment Plan plus referral for rebated psychology sessions.
A 60-year-old has taken diazepam 10 mg three times daily for 8 years and wants to stop. What is the safest approach?
- AAdd a second benzodiazepine
- BSwap to alprazolam
- CStop immediately
- DHalve the dose daily until stopped in 4 days
- EGradual taper over weeks to months
Show answer and explanation
Answer E. Long-term benzodiazepines should be tapered gradually (for example 10 to 25% every 2 to 4 weeks), adjusting to symptoms, to avoid withdrawal including seizures. Diazepam's long half-life suits tapering. Psychological support improves success.
Learning point: Benzodiazepine withdrawal: slow taper (10 to 25% every 2 to 4 weeks) with support.
Practise more mental health questions free
Every mental health subtopic in our bank
The bank holds 30 mental health questions across 30 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- ADHD in adults1
- Alcohol brief intervention1
- Alcohol withdrawal risk1
- Antidepressant discontinuation1
- Antipsychotic metabolic monitoring1
- Benzodiazepine dependence1
- Bipolar disorder lithium monitoring1
- Child and youth mental health services1
- Clozapine side effect1
- Delirium in an older patient1
- Dementia diagnosis1
- Eating disorder warning signs1
- Gambling harm1
- Generalised anxiety disorder1
- Insomnia management1
- Involuntary treatment1
- Lithium toxicity1
- Mental Health Treatment Plan1
- Methamphetamine use1
- Opioid dependence treatment1
- Opioid overdose prevention1
- Panic disorder treatment1
- Perinatal depression screening1
- Postnatal psychosis1
- Serotonin syndrome features1
- Serotonin toxicity risk1
- Smoking cessation pharmacotherapy1
- SSRI starting advice1
- Suicide risk assessment1
- Youth mental health service1
Common questions
Which mental health topics appear in the AKT?
Recent reports list major depressive disorder, bipolar disorder, generalised anxiety disorder, eating disorders and self-harm.
What is a mental health treatment plan for?
It allows Medicare-subsidised sessions with psychologists and other eligible providers under Better Access.
Which tool measures distress in a mental health plan?
The K10 is commonly used, with PHQ-9 and GAD-7 for depression and anxiety severity.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.