Priority 3 - Initiatives to Promote Collaborative Primary Health Care

Another factor in mental health consumers ‘missing out’ on appropriate services and timely treatment is the user pays system. Many simply cannot afford the cost of luxury ‘private’ services and many cannot afford the cost of private health insurance. Health insurance is becoming more and more out of reach for the ‘average’ Australian, let alone someone who tries to exist on a disability support pension.

Clinician, Queensland , Submission #105, Not For Service, p.190

It is Time for Service for people needing access to primary mental health care.

Time for Service strongly supports a massive expansion in the role of allied health professionals, particularly psychologists, in providing quality mental health services. However, we must ensure that we don’t create a system in which people needing mental health care face large out of pocket expenses for services. This is a real and growing problem with existing fee for service funding models.

Instead, Time for Service proposes a system where people living right across Australia, from metropolitan, regional, rural and remote areas can access the services they need when they need them.

New and innovative models of funding are required to enable better access to psychology services, and we need this access to be part of a collaborative package of care with GPs, nurses, other allied health professionals, plus non-clinical community support.

One key initiative already in place is the Commonwealth’s ‘Better Outcomes in Mental Health Care’ (BOiMHC) program. But with only 20% of GPs registered to make referrals to psychologists under this initiative, there are severe restrictions on public access to these services.

The Commonwealth must provide funds to facilitate more widespread access to psychology services while maintaining the vital collaborative aspects of the Better Outcomes Program. Better access to services would be achieved by:

• geographically-based multidisciplinary primary mental healthcare teams that could be led by a ‘community coordinator’ – these could be registered psychologists or other allied health professionals employed through the Divisions of General Practice Network or NGOs;
• funding to enable the employment of psychologists within, or across, GP practices;
• implementation of multidisciplinary education, training and support for GPs, allied health professionals and other relevant community workers;
• the development of enhanced systems of integration between primary care and public mental health systems to improve referral and discharge protocols, shared care arrangements and improved communication flows;
• incentives for practice change by GPs to accommodate new ways of delivering mental health care; and
• real investment in building a better-trained and larger workforce.
• Enhanced access to collaborative primary mental health care is particularly important for the at risk groups currently poorly serviced; people living outside metropolitan areas, youth, indigenous people and those with co-existing alcohol or drug problems.

Expenditure Required: $300m per annum.