Psy­chol­o­gists call for bet­ter use of fund­ing

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

PSY­CHOL­O­GISTS are ar­gu­ing for a re­dis­tri­bu­tion of funds from the fed­eral Gov­ern­ment’s Bet­ter Ac­cess scheme for men­tal health, say­ing they — not GPs as cur­rently — should take the main role in plan­ning treat­ment.

Lyn Lit­tle­field, chief ex­ec­u­tive of the Aus­tralian Psy­cho­log­i­cal So­ci­ety, says the cur­rent Bet­ter Ac­cess scheme is ‘‘ un­bal­anced’’ be­cause nearly half the fund­ing goes to GPs for draw­ing up care plans for pa­tients, rather than on the treat­ment it­self.

Pro­fes­sor Lit­tle­field told Week­end Health that GPs ‘‘ aren’t highly trained in men­tal health’’ and if the Gov­ern­ment wanted cuts in the scheme, ‘‘ large cost sav­ings’’ could be made by scrap­ping the ex­ist­ing $150 re­bate for GPs to draw up care plans.

‘‘ The ma­jor­ity of the time the psy­chol­o­gists have to do their own as­sess­ment (of the pa­tient’s needs) be­cause the GP hasn’t done it prop­erly,’’ she said. ‘‘ Quite of­ten we are dou­bling up. I think it should be col­lab­o­ra­tive — pa­tients should go to the GP first of all, so they can do their own as­sess­ment.

‘‘ Then when the GP has found they have some sort of men­tal health dis­or­der, the psy­chol­o­gist should do the full as­sess­ment and work up a plan and con­sult with the GP that they are happy with that plan. GPs get $150 for do­ing the plan — you would have large cost sav­ings there.’’

The cost of the Bet­ter Ac­cess scheme to the end of 2007 was $279 mil­lion, Lit­tle­field said. Of that, $121 mil­lion went to GPs, most of it to com­pile men­tal health plans. An­other $21 mil­lion went to psy­chi­a­trists, whereas $131 mil­lion went to al­lied health pro­fes­sion­als, mainly psy­chol­o­gists.

Kate Car­nell, CEO of the Aus­tralian Gen­eral Prac­tice Net­work, re­jected Lit­tle­field’s claims, say­ing there was ‘‘ no ev­i­dence’’ that GPs were not do­ing plans prop­erly.

‘‘ I think it’s re­ally im­por­tant to see this whole approach to men­tal health holis­ti­cally — it isn’t just about psy­chol­o­gists, or for that mat­ter GPs,’’ Car­nell said.

‘‘ It should be about the pa­tient. You’ve got to look at what’s re­ally hap­pen­ing — 90 per cent of GPs are bulk-billing their men­tal health pa­tients, and only 30 per cent of psy­chol­o­gists are bulk-billing.

‘‘ Maybe the thing we should be talk­ing about is mak­ing (psy­chol­ogy) ser­vices avail­able out­side ur­ban ar­eas and in a few more re­gional and rural ar­eas — that’s the main prob­lem we have in this (men­tal health) area at the mo­ment.’’

Lit­tle­field also de­fended psy­chol­o­gists af­ter a break­down of Bet­ter Ac­cess scheme fig­ures showed that fewer than one-third of psy­chol­o­gists’ ser­vices were bulk-billed. Ac­cord­ing to the fig­ures, re­leased by the fed­eral health min­is­ter Ni­cola Roxon last week, 30.4 per cent of the nearly 1 mil­lion con­sul­ta­tions pro­vided by reg­is­tered psy­chol­o­gists, and 25.9

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