Patient referrals failing guidelines
From Health cover above this — the Australian Psychological Society recommends its members charge $192 — leaving patients with an out-ofpocket ‘‘ gap’’ of at least $80.
Hall says a lack of guidelines and training about how to use the new items is responsible for the high rate of referrals from GPs of patients who had no mental health treatment plan prepared. In many cases this means psychologists have to spend extra time with the patient to figure out their diagnosis, refer them back to the GP, or chase the GP for more information on the patient.
‘‘ The problem is that many GPs are not aware of the vast array of psychological services that are currently covered by the rebate,’’ Hall said.
Elizabeth Moh, a psychology student working on a placement with Hall, said there hadn’t ‘‘ been much guidance for psychologists and GPs. We don’t want to be critical of GPs — it’s more that the Government hasn’t provided enough guidance,’’ Moh said. ‘‘ The system isn’t working as well as it should.’’
The concerns echo criticisms of the Government’s mental health reforms, reported in The Australian last month, by Ian Hickie — previously one of the leading advocates for the measures.
In a paper published last weekend in the Medical Journal of Australia (2007;187:100-103), professor Hickie and coauthor Patrick McGorry, executive director of the Orygen Youth Health Research Centre at the University of Melbourne, stepped up the attack on the new system.
The article suggested while the medical profession might be happy with the reshaped program, because it was less onerous and restrictive, patients ‘‘ may be poorly served by a failure to support a genuine increase in widespread access to affordable and collaborative care’’.
Hickie, the executive director of the Brain and Mind Research Institute in Sydney, says the revelations that up to half of GP referrals are being made without a mental health plan ‘‘ cuts to the chase’’ of the concerns over the new scheme.
‘‘ The most ideal form of care is collaborative care, with GPs, psychologists and psychiatrists working as a team,’’ he told WeekendHealth .
‘‘ What has happened here, unfortunately, is that many of the essential elements of collaborative care are no longer required, and it’s simply left to the individual professionals to pursue or not.
‘‘ The danger is people will say it’s all the GPs’ fault, but I don’t think that’s fair — the system needs to promote, reward and require better practice.’’
Concerned: Janet Hall says significant patients arrive for treatment without a GP plan