GPs over­look psy­chol­ogy re­fer­ral guide­lines

The Weekend Australian - Travel - - Health - Adam Cress­well Health ed­i­tor

PA­TIENTS are com­monly be­ing re­ferred for psy­cho­log­i­cal treat­ment with­out men­tal health plans be­ing com­pleted first by their GP, an omis­sion that could jeop­ar­dise their right to claim Medi­care re­bates.

One Vic­to­rian psy­chol­ogy prac­tice has re­vealed up to half the pa­tients re­ferred to it by GPs come with­out men­tal health plans, which are sup­posed to be the cor­ner­stone of the fed­eral Gov­ern­ment’s men­tal health re­forms an­nounced last year.

Un­der the re­forms, which came into ef­fect last Novem­ber, pa­tients can re­ceive Medi­care re­bates for treat­ment by a psy­chol­o­gist, pro­vided they have been re­ferred by a GP who has com­pleted a men­tal health plan for the pa­tient.

They have also greatly widened the num­ber of psy­chol­o­gists who can see pa­tients un­der Medi­care, in ad­di­tion to the clin­i­cal psy­chol­o­gists who al­ready had lim­ited ac­cess to the scheme, by in­clud­ing a sep­a­rate re­bate for ‘‘ fo­cused psy­cho­log­i­cal strate­gies’’ pro­vided by lesser-qual­i­fied psy­chol­o­gists, oc­cu­pa­tional ther­a­pists and so­cial work­ers.

The new scheme over­all is meant to pro­mote co-op­er­a­tion and a team approach be­tween GPs, psy­chi­a­trists and psy­chol­o­gists. It re­places a pre­vi­ous scheme, known as Bet­ter Out­comes in Men­tal Health, which had been crit­i­cised for its capped na­ture, which saw funds in many ar­eas ex­hausted be­fore it had run its course.

The pre­vi­ous scheme also re­quired GPs to com­plete a train­ing scheme in or­der to par­tic­i­pate in the pro­gram, a hur­dle the new ar­range­ments have dis­pensed with.

But doc­tor Jan Hall, from the Rich­mond Psy­chol­ogy Clinic in Melbourne, says that since the new ar­range­ments came into force last Novem­ber pa­tients re­ferred to the clinic by a GP who had com­pleted a men­tal health plan ac­counted for 24 per cent of to­tal re­fer­rals.

Pa­tients re­ferred by a GP with a plain let­ter, and no men­tal health plan, ac­counted for 21 per cent.

Ex­plana­tory notes at the back of the Novem­ber 2006 edi­tion of the Medi­care Ben­e­fits Sched­ule say re­bates will not be payable for psy­chol­ogy treat­ment ‘‘ un­less . . . the pa­tient is be­ing man­aged un­der a GP Men­tal Health Care Plan’’.

As­sum­ing the pa­tient is el­i­gi­ble, the Medi­care re­bate for an ini­tial as­sess­ment of up to 12 planned treat­ment ses­sions with a clin­i­cal psy­chol­o­gist is $110 per con­sul­ta­tion, or $75 if the treat­ment is pro­vided by one of the lesser-qual­i­fied psy­chol­o­gists.

How­ever, most psy­chol­o­gists charge well

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