The Better Access initiative and the role of GPs

The Better Access initiative and the role of GPs

The Better Access initiative (introduced by the Australian Government in 2006) aims to improve health outcomes by providing targeted treatment for people with a clinically diagnosed mental disorder.

How does the Better Access initiative work?

The Better Access initiative allows eligible people with an assessed mental disorder to access rebated mental health services for which they can receive a rebate. At the time of publication, each person is entitled to access up to 10 individual services and up to 10 group services per calendar year.

Patients can access more than 10 individual services and/or more than 10 group services, but they can receive rebates for only the first 10 individual services and only the first 10 group services within a calendar year.

For up-to-date information, visit the Department of Health website at: https://www.health.gov.au/initiatives-and-programs/better-access-initiative?utm_source=health.gov.au&utm_medium=callout-auto-custom&utm_campaign=digital_transformation

Eligibility for rebated services

Patients with an assessed mental disorder are eligible to access services under the Better Access initiative sessions when they are referred to an approved provider by:

• a GP managing the patient under a GP MHTP
• a referred psychiatrist assessment and management plan, or
• a psychiatrist or paediatrician.

Approved providers

Approved providers are:

• GPs who are registered as a provider of Focussed Psychological Strategies (FPS)
• psychologists
• appropriately trained and accredited social workers and occupational therapists.

Useful resources Department of Health. Better Access initiative.  Services Australia. Better Access initiative – supporting mental health care.

Mental disorders applicable under the Better Access initiative

At the time of publication, the following mental disorders are eligible for treatment under the Better Access initiative, as per the International Classification of Diseases, 10th Revision (ICD-10).

. acute psychotic disorders	· enuresis
. adjustment disorder	· generalised anxiety
· alcohol-use disorders	· hyperkinetic (attention deficit) disorders
· bereavement disorders	· mental disorder, not otherwise specified
· bipolar disorder	· mixed anxiety and depression
· chronic psychotic disorders	· neurasthenia
· conduct disorder	· panic disorder
· depression	· phobic disorders
· dissociative (conversion) disorder	· sexual disorders
· drug-use disorders	· sleep problems
· eating disorders	· unexplained somatic complaints.

As it is likely ICD-11 will be adopted during the 2023–25 triennium, there may be variation to the above list of mental disorders applicable under the Better Access initiative.

‘Mental disorder, not otherwise specified’

The condition listed above as ‘mental disorder, not otherwise specified’ covers any mental disorder that does not meet the description of any other mental disorder in the ICD-10. Similar to the ‘not otherwise specified’ codes in the Diagnostic and statistical manual of mental disorders, it allows for atypical cases. For a patient to be diagnosed with this condition, they must have mental health symptoms that reach the threshold for clinical significance but do not fall neatly into one of the disorder categories.

Organic mental disorders, such as those due to brain damage, are excluded under ‘mental disorder, otherwise not specified’.

Mental disorders not applicable under the Better Access initiative

In addition to organic mental disorders, the following are not applicable under the Better Access initiative:

• delirium
• dementia
• mental retardation
• tobacco-use disorders.

Although not applicable under the Better Access initiative, GPs can address these disorders if a patient with an applicable mental disorder has comorbidity with one or more of these disorders (for example, when a patient has dementia and generalised anxiety).

Useful resources World Health Organization. International Classification of Diseases 10th edition (ICD-10).  World Health Organization. International Classification of Diseases 11th edition (ICD-11).

 

The role of the GPMHSC and GPs in the Better Access initiative

The GPMHSC sets and monitors the training standards for GPs that allow them to deliver services during general practice consultations that correspond to mental health MBS item numbers.

Table 1 sets out services and the corresponding MBS item numbers that GPs can claim based on their mental health training.

Table 1. GPs’ eligibility to provide mental health MBS items

Mental health training	Services	MBS item numbers	MBS rebate
None	Preparation of a patient’s GP MHTP	2700 2701	Minimum MBS rebate
Level 1: MHST	Preparation of a patient’s GP MHTP	2715 2717	Maximum [higher schedule] MBS rebate
Level 2: FPS ST	Registered to provide FPS interventions to patients for their mental health conditions as identified in the patient’s GP MHTP	2721 2723 2725 2727	MBS rebates apply for up to 10 individual FPS sessions and 10 group sessions per person per calendar year

FPS, Focussed Psychological Strategies; FPS ST, Focussed Psychological Strategies Skills Training; GP MHTP, General Practice Mental Health Treatment Plan; MBS, Medicare Benefits Schedule; MHST, Mental Health Skills Training

Useful resources Department of Health. MBS Online.  GPMHSC. Mental health MBS item number descriptors and rebates.