Since its inception eight years ago, the Better Access to Mental Health Care program has significantly improved the management of mental health problems. While the program allows for the treatment of a broad range of mental health disorders, the great majority of issues managed by general practitioners under the scheme relate to depression and/or anxiety.
The Better Access program is open to all GPs and replaced the previous Better Outcomes program that was available only to GPs who had undergone specific psychological training.
BEACH data analysis has shown that compared to Better Outcomes, the new program significantly increased the rates of depression management in primary care, with a halving of the referral rate to psychiatrists, a six-fold increase in referrals to psychologists, and no change in medication rates.
The Health Department's own analysis found that Better Access reached a much larger number of patients than previously, was cost effective and reduced levels of distress from high or very high to moderate. However, it found that its uptake was greatest amongst city dwellers and those from higher socio-economic groups. Thus poorer and rural patients, and those aged less than 15 years, tended to miss out.
The Access to Allied Psychological Services (ATAPS) is another Commonwealth initiative to address mental health issues. It was launched over ten years ago and in recent years has been re-targeted to reach out to these vulnerable groups. Like Better Access, ATAPS has also found to be effective in reducing psychological distress.
Most North Coast GPs are happy with the Better Access program for patients who can afford a co-payment for psychological services. Over the years they have built up referral patterns that work well for themselves, the psychologist and the patient. Accessing services for poorer patients, however, is often difficult and is limited by factors such as a fixed annual government grant for the service, or changing staff.
To help address these issues North Coast Medicare Local has developed their Healthy Minds program and Online Portal. Healthy Minds focuses on providing short-term mental health support (initially 6 x one-hour sessions) to vulnerable groups. Funding from both ATAPS and Better Access makes it available to those with a health care card (or are under severe financial distress) at no cost to the patient.
Healthy Minds prioritises the homeless, refugees, children (particularly those affected by forced adoption), Indigenous people, sufferers of perinatal depression and those at mild to moderate suicide risk.
Many such patients do not have a GP. Through their partnerships with local service organisations, such as those dealing with unemployment, homelessness, domestic violence and family support, NCML is linking patients to GPs and in turn to mental health workers, many of whom are already embedded in these support organisations.
Due to its funding arrangements, Healthy Minds is not available to those who have had a GP Mental Health Care Plan or used ATAPS in the current calendar year. It is also not suitable for those with major psychiatric issues that should continue to be managed by Local Health District Mental Health Services or psychiatrists.
To ease the GPs’ burden the referral process is simple. Complete a Healthy Minds Referral Form and Treatment Plan and fax it to the intake offices in Tweed (07 5523 5596) or Lismore (02 6627 3396).Referral forms that auto-populate the required fields are available for Best Practice and Medical Director.