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Articles

Better outcomes in mental health care initiative
Edited by Gavin Andrews MD, UNSW, Jan 03


Most people with a mental disorder who seek help from a health professional, seek help from their general practitioner rather than from a specialist mental health professional. In recognition of this, the Commonwealth is supporting general practitioners to build a strong system of primary mental health care and the Better outcomes in mental health care initiative was announced in the 2001 Budget. The initiative will improve the community's access to primary mental health services by providing better education and training for general practitioners and more support for them from allied health professionals and psychiatrists. It encourages evidence-based practice in primary mental health care and recognises that good practice in mental health includes both pharmacological and non-pharmacological interventions.

The Better outcomes in mental health care initiative has five major components. These components are:

1. Education and training for general practitioners - to familiarise them with the initiative and to increase their mental health care skills and knowledge.

2. The 3 Step Mental Health Process - which rewards effective management of mental health problems by general practitioners through assessment, care planning and review. This component commenced on 1 July 2002.

3. A new Medicare Benefit Schedule item for General Practitioner Focussed Psychological Strategies (FPS). This component commences on 1 November 2002. General practitioners are required to have appropriate training for the provision of FPS and be registered with the Health Insurance Commission. Details of the training and accreditation requirements can be found on the General Practice Mental Health Standards Collaboration website http://www.racgp.org.au/folder.asp?id=650.

4. Access to allied health services - to enable general practitioners registered with the initiative to access focussed psychological strategies from allied health professionals to support their patients with mental health problems. This component is rolling out through 16 pilots in 2002-2003, with Divisions of General Practice as fundholders.

5. Access to psychiatrist support - changes to the case conferencing component of the Enhanced Primary Care MBS items for consultant physicians from 1 May 2002 supports psychiatrists to participate in case conferencing. Planning for the provision of consultancy advice to general practitioners in emergency situations is still underway.

Requirements for the provision of Focussed Psychological Strategies (FPS) under the General Practitioner MBS item for FPS.

Doctors eligible to use the MBS item for FPS are:

  • medical practitioners including general practitioners, but excluding specialists and consultant physicians;
  • registered with the HIC as participating in the Better outcomes in mental health care initiative;
  • have completed the relevant FPS training requirements and are registered with the HIC to use these item numbers; and
  • provide FPS services from a practice that is either participating in the Practice Incentive Program or is an accredited general practice.

    Requirements for General Practitioner Referral of Patients for Focussed Psychological Strategies

    Where general practitioners determine that psychological interventions are the preferred treatment for patients with mental health disorders, they may still use any existing pathways and systems to access these services, such as referral to a psychiatrist or to existing public or private mental health sector services.

    However general practitioners who are registered with the HIC as participating in the Better outcomes in mental health care initiative, have two additional pathways available to access FPS for their patients with defined mental health disorders. The decision to refer a patient must be made in the context of the 3 Step Mental Health Process. The additional pathways are:

    1. in the Access to Allied Health Pilot sites, the General Practitioner may refer to a specific allied health professional for the provision of FPS for the defined mental health disorders; and

    2. in all areas, FPS may be provided by General Practitioners who are registered with the HIC for the provision of FPS. Where the referring General Practitioner also has the required FPS registration, they can provide these services themselves. Where they do not have the required FPS registration, they can refer to another General Practitioner who has this registration for the provision of FPS for the defined mental health disorders.

    For more information on General Practitioner remuneration for the provision of FPS and the MBS rebate levels, please refer to the November 2002 Medicare Benefits Schedule.

    For more information on the Better outcomes in mental health care initiative, please refer to the Familiarisation Training Manual on the Mental Health and Special Programs Branch of the Department of Health and Ageing website: http://www.mentalhealth.gov.au/budget/infosheets.htm.

    Edited by Gavin Andrews MD, UNSW, Jan 03
    2003 CRUfAD


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