Better Access Mental Health

Program Overview and Rationale

The Better Access Initiative encourages all GPs to work more closely and collaboratively with psychiatrists, clinical psychologists, psychologists, occupational therapists and social workers to achieve a common purpose – improved patient outcomes in the area of mental health.

Better Access provides a system of care that encourages more GPs to participate in early intervention, assessment and management of patients with mental disorders. It streamlines access to appropriate psychological interventions in primary care by providing MBS items to clinical psychologists, psychologists, social workers and occupational therapists.

The GP-psychiatry support component of Better Outcomes has also been retained and expanded under the Better Access Initiative, leading to expectations that more private psychiatrist will be encouraged to see more new patients. The links and referral pathways between psychiatrists and paediatricians to clinical psychologists, psychologists, occupational therapist and social workers have been strengthened under Better Access, leading to improved continuity of care for people experiencing mental disorders.

Duration of Program and how it operates

From 1 November 2006, where a patient has a mental health disorder only, it is anticipated that they will be managed using the new GP Mental Health Care items.

·         Item 2710 or Item 2702 – Preparation of a GP Mental Health Treatment Plan
      -     Item 2710 to be billed if GPs have completed accredited Mental Health Skills training
      -     Item 2702 to be billed if GPs have not completed accredited Mental Health Skills training
·         Item 2712 – Review of a GP Mental Health Treatment Plan
·         Item 2713 – GP Mental Health Care Consultation

How the Program benefits GPs and their patients

General practitioners (GPs) are well placed to provide mental health care to the majority of those suffering with a mental health disorder. Indeed, most people who seek help for their mental health problem do so from their GP.

The Mental Health Care item numbers under Better Access

-       Provides increased community access to mental health professionals and team based care
-       Encourages GPs to work more closely and collaboratively with psychiatrists, psychologists, OT’s and Social Workers
-       Encourages early intervention, assessment and management of patients with mental disorders
-       Encourages private psychiatrists to see more new patients

Psychiatrist Medicare Items

New and amended MBS item numbers for GPs seeking psychiatrist support have been introduced since 1 November 2006. They provide incentives for psychiatrists to see new patients and to refer patients for management plans by GPs where clinically appropriate.

Increased rebates for existing items 291 and 293 will continue to promote collaborative care between specialist and primary mental health care providers by encouraging psychiatrists to prepare referred patient assessment and management plans for patients being managed by GPs in general practice.

Psychiatrist Items	Item	Medicare Fee	Patient Rebate
Referred Patient Assessment and Management Plan	291	$418.20	$355.50
Review of Management Plan	293	$261.40	$222.20
Initial Consultation, New Patient	296	$240.45	$204.40

Where a GP is managing a patient with a mental disorder under a referred patient assessment and management plan from a psychiatrist, the GP can continue to manage the patient using standard consultation items.

For patients with a referred patient assessment and management plan from a psychiatrist, GPs are able to use, as necessary, the GP Mental Health Care Review item (item 2712) and the GP Mental Health Consultation item (item 2713) for the ongoing management of the patient, as if the patient had a GP Mental Health Treatment Plan.

If a GP determines that the patient requires a GP Mental Health Treatmjent Plan in addition to the management plan prepared by the psychiatrist, the GP is able to prepare a GP Mental Health Plan using item 2710 or 2702 (see page 1 for explanation).

As a general principle, the creation of multiple plans should be avoided unless the patient clearly requires an additional plan. In these cases, you should be satisfied that your peers would regard the provision of an additional plan as appropriate for that patient, given the patient’s needs and circumstances.

Further information can be obtained from the Department of Health and Ageing and ADGP websites, www.mentalhealth.gov.au, www.agpn.com.au and www.ranzcp.org.

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