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The Better Access initiative and the role of GPs

In 2006, the Commonwealth Government introduced Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative.

Better Access aims to improve health outcomes through targeted treatment of people with a clinically diagnosed mental illness.

How does Better Access work?

The Better Access initiative entitles people with an assessed mental illness to access rebated allied mental health services.

For each eligible person, this includes up to 10 individual services and up to 10 group services per calendar year. This is correct at the time of writing, but is subject to change. For up-to-date information, visit the Department of Health (DoH) website at www.health.gov.au/internet/main/publishing.nsf/Content/mental-ba-fact-pat

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

Eligibility for rebated services

Patients with an assessed mental disorder are eligible for Better Access sessions when referred:

  • by a GP managing the patient under a GP Mental Health Treatment Plan (GPMHTP)
  • under a referred psychiatrist assessment and management plan, or
  • by a psychiatrist or paediatrician.

One of the above professionals would then refer the patient to an approved provider of Better Access for the rebated sessions.

Approved Better Access providers

Approved Better Access providers include:

  • GPs who are registered as a provider of Focussed Psychological Strategies (FPS)
  • clinical psychologists
  • registered psychologists
  • appropriately trained and accredited social workers and occupational therapists.
The GPMHSC does not endorse any diagnostic tool for GPs, who may choose the assessment method and diagnostic tool they believe to be the most suitable. This is correct at the time of printing, but is subject to change. For up-to-date information, visit the Department of Health website.
 

You can also provide ongoing management of a patient with mental illness by conducting reviews of their GPMHTP and providing consultations to review their progress. These services are not included in the 10 rebated sessions, can be provided when appropriate and have specific MBS item numbers.

Renewing a patient’s GPMHTP

GPMHTPs do not expire at the end of a calendar year, so the patient does not need a new plan to continue their GPMHTP into the next calendar year unless the referring practitioner considers it is clinically required.

This means that a patient can continue to be eligible for rebated allied mental health services in the next calendar year under their existing plan if the referring GP assesses that the patient continues to need these services.

Generally, new plans should not be developed within 12 months of the previous plan, unless the referring practitioner considers it clinically required.

A GP can assess and manage the patient’s progress and write a new referral for further services using any of the following items:

  • a GPMHTP review item
  • a GP mental health consultation item
  • standard GP consultation item.

Mental illnesses applicable under Better Access

The training accredited by the GPMHSC provides the fundamental skills required to assess a patient’s needs, recommend appropriate referral options and manage a patient’s ongoing mental healthcare.

At the time of printing, the following mental illnesses/disorders are eligible for treatment under Better Access, as per the International classification of diseases, 10th revision (ICD-10). Refer to the International classification of diseases 11th revision (ICD-11) when it is released for up-to-date information.

  • Acute psychotic disorders
  • Adjustment illness
  • Alcohol-use disorders
  • Bereavement disorders
  • Bipolar illness
  • Chronic psychotic disorders
  • Conduct illness
  • Depression
  • Dissociative (conversion) illness
  • Drug-use disorders
  • Eating disorders
  • Enuresis
  • Generalised anxiety
  • Hyperkinetic (attention deficit) illness
  • Mental illness, not otherwise specified
  • Mixed anxiety and depression
  • Neurasthenia
  • Panic illness
  • Phobic disorders
  • Sexual disorders
  • Sleep problems
  • Unexplained somatic complaints

Mental illnesses not applicable under Better Access

  • Dementia
  • Tobacco-use illness
  • Delirium
  • Mental retardation

Although these are not mental illnesses applicable under the Better Access initiative, you can address them when patients who present with mental illness have comorbidity with one or more of these conditions (eg when you are treating a patient who has impaired cognition and mental illness).

The role of the GPMHSC and GPs in Better Access

The GPMHSC sets and monitors the training standards for GPs that correspond to mental health MBS item numbers for GP consultations. Table 1 sets out services you can provide based on your mental health training. For details about the relevant MBS item numbers and rebates, see Appendix 1 on page 25.

Table 1. Service provision eligibility

 

Training

Services

No Mental Health Skills Training (MHST)

Preparation of a patient’s GPMHTP (minimum Medicare rebate applies)

Level 1: MHST

Preparation of a patient’s GPMHTP
(maximum [higher schedule] Medicare rebate applies)

Level 2: FPS ST
Focussed Psychological Strategies
Skills Training (FPS ST) and Focussed
Psychological Strategies Continuing
Professional Development (FPS CPD)

Registered to provide FPS interventions to patients for their mental health conditions as identified in the patient’s
GPMHTP
(Medicare rebates apply for up to 10 FPS sessions per person per calendar year)

If and when the requirements, item numbers, or rebates change, the GPMHSC will update the standards and training requirements accordingly.

For more information about Better Access, visit the Australian Government Department of Health’s website.

* The GPMHSC does not endorse any diagnostic tool for GPs, who may choose the assessment method and diagnostic tool they believe to be the most suitable.
* This is correct at the time of printing, but is subject to change.


Downloads

Mental-health-training-standards-2020-22_A-guide-for-GPs.pdf