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What is a Mental Health Treatment Plan and how do I get one?

By Remie Jaggard

mental-health-care-planThe Australian government introduced Medicare’s Better Access Initiative with the purpose of improving the treatment and management of mental illness within the Australian community. The initiative aims to increase community access to mental health professionals and team-based mental health care, with GPs encouraged to work more closely and collaboratively with psychiatrists, clinical psychologists, registered psychologists and appropriately trained social workers and occupational therapists. Under this initiative, clients can access Medicare rebates through a Mental Health Treatment Plan for psychological services to cover part of their consultation cost. These rebates can only be accessed through a referral by your general practitioner (GP), psychiatrist or paediatrician, and require a Mental Health Treatment Plan to be completed. Allied mental health services which can be claimed through this initiative include psychological services, social work and occupational therapists.

The Better Access Initiative and its subsequent rebates are only available to patients with an assessed mental disorder who would benefit from a structured approach to their treatment needs. A mental disorder is a term used to describe a range of clinically diagnosable disorders that impact an individual’s emotional, cognitive and social abilities. The table below illustrates which disorders can be treated through this initiative.

·         Alcohol Use disorder

·         Anxiety disorders

·         Adjustment disorder

·         Attention Deficit disorder

·         Bereavement disorders

·         Bipolar disorders

·         Conduct disorder

·         Co-occuring anxiety and depression

·         Depression

·         Drug use disorder

·         Eating disorders

·         Obsessive Compulsive disorder

·         Panic disorder

·         Phobic Disorder

·         Posttraumatic stress disorder

·         Psychotic disorders

·         Schizophrenia

·         Sexual disorders

·         Sleep problems

 

What rebates will I receive from Medicare?

Under Medicare’s Better Access Initiative clients are able to receive a rebate for some of the consultation cost of approved allied mental health services (including psychological services). These rebates can only be accessed by a referral from your general practitioner (GP), psychiatrist or paediatrician. Rebates for seeing a Clinical Psychologist are currently $124.50 per consultation, and rebates for seeing a registered Psychologist are currently $84.80 per consultation.

How do I access these services under Medicare?

Step 1:

  • You will need to visit your GP who will then assess whether you have a mental disorder and whether the preparation of a Mental Health Treatment Plan is appropriate for you given your mental health, healthcare needs and circumstances.
  • Should you be diagnosed with a mental disorder your GP will either prepare a Mental Health Treatment Plan or instead refer you to a psychiatrist who will prepare a psychiatrist assessment and management plan.
  • Alternatively your GP may refer you to either a psychiatrist or paediatrician who will conduct an assessment. If the diagnosis remains, they will directly refer you to an allied mental health service.
  • Whether or not you are eligible to access allied mental health services is up to the discretion of your treating health practitioner to determine.

Step 2:

  • You can be referred for certain Medicare rebateable allied mental health services once you have a:
    • GP Mental Health Treatment Plan in place
    • Or are being managed by a GP under a referred psychiatrist assessment and management plan
    • Or have been referred by a psychiatrist or paediatrician
  • Your GP can refer you for up to six sessions of individual or group allied mental health services.
  • It is up to the clinical discretion of your referring practitioner as to how many sessions of allied mental health services you will be referred for. Practitioners are able to initially refer for a total of six sessions of allied mental health services.

Step 3:

  • Depending on your health care needs, you may return to your GP or psychiatrist/paediatrician to obtain a new referral and subsequently obtain an additional four sessions should you require more following the initial course of treatment (the first six referred services).
  • There is a maximum of ten sessions of allied mental health services which can be referred by a GP, psychiatrist or paediatrician per calendar year. Once the calendar year has ended you are able to access another Mental Health Treatment Plan.
  • Whether you are eligible to access the additional allied health services that are rebateable is your treating health practitioner’s decision. A review of your GP Mental Health Treatment plan will be conducted in accordance with a written report from the allied mental health professional at the completion of treatment.

If you would like some more information on the Better Access Initiative and Medicare rebates you can follow these links:

http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-ba-fact-pat

https://www.psychology.org.au/medicare/fact_sheet/

 

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