The government plans to divert treatment to the most complex patients and cut overtreatment of the less needy, but details are sketchy. Patients considered to have “mild” mental illness will be shunted away from services such as Better Access in favour of online and self-help services, as part of the government’s mental health care shake up. […]
The government plans to divert treatment to the most complex patients and cut overtreatment of the less needy, but details are sketchy.
Patients considered to have “mild” mental illness will be shunted away from services such as Better Access in favour of online and self-help services, as part of the government’s mental health care shake up.
The changes would see a more “customised” approach to mental health service delivery, the government said of the reforms, outlined in a report released last week.
Over the next three years the government will overhaul Australia’s mental health care system, which will include funnelling $350 million to Australia’s 31 Primary Health Networks (PHNs).
Big changes to Better Access, which services 1.7 million people annually, will be part of the roll-out, the Turnbull government announced in the report, a response to the Review of mental health services review conducted by the National Mental Health Commission.
The modified Better Access Program will “encourage more judicious referral to Medicare based services targeting people whose needs cannot be met through other first-line responses”, the report states.
No new funding will be allocated, and Prime Minister Malcolm Turnbull said the government already spends $10 billion on mental health annually.
The report also recommended that Primary Health Networks be able to cash out Medicare payments to establish a better integrated and comprehensive model than the current “fragmented” one.
The newly-established PHNs will have a more flexible funding pool that can commission more locally appropriate services, including access to mental health nurses, psychological treatments, vocational services, drug and alcohol services and peer support.
“[This] will progressively roll together primary mental health care programmes. Responsibility for this pool of funding will sit with PHNs,” the report states.
In part, the money will come from reduced utilisation of these services for patients with “lesser needs”, who would instead be directed to self-help or low intensity services.
While GPs will be encouraged to direct patients with severe and complex needs to face-to-face psychological services, those with mild mental illness would be directed to less intensive resources where appropriate.
To support primary care in this stepped-care model, the government has suggested the development new digital mental health gateway, which would include a website and single phone number as the first point of service for consumers seeking information or advice.
The AMA said this approach correctly identifies the need for local planning delivery in mental health services, but they echoed the concern around how the PHNs would cope and the potential withdrawal of the federal government from funding and program delivery.
“Funding for mental health services will sit with the PHNs, which will work in partnership with Local Hospital Networks to commission services that are better targeted for people with mental health needs,” said AMA president Professor Brian Owler.
“The AMA hopes that this model will deliver genuine patient-centred care and not the opposite, whereby the PHN decides what package of care people can have, based on the services it has chosen to organise,” he said.
The review also highlighted the need to move funds away from acute and crisis services, and instead towards preventative and early intervention.