Table 2.

Better Outcomes in Mental Health Care (Australia)

The 2001–2002 Federal budget initiative Better Outcomes in Mental Health Care (BOiMHC) seeks to improve the mental health care available to Australians. It has five interconnected components, each of which is described below:

1. Education and training for general practitioners: Through this component, general practitioners can participate in Familiarisation Training which introduces them to the Better Outcomes in Mental Health Care program (2 hours), then Level 1 Training which equips them to perform the 3-step mental health process (6 hours), described below and then Level 2 Training which provides them with the skills necessary to undertake focused psychological strategies (20 hours), also described below. Level 1 Training is a prerequisite for participation in the other components of the initiative. An RACGP sub-committee called the General Practice Mental Health Standards Collaboration oversees this component.

2. The 3 Step Mental Health Process: This component provides a framework for general practitioners to manage mental health problems, and includes an assessment (Step 1), preparation of a mental health plan (Step 2) and a review (Step 3). General practitioners who have completed Level 1 Training can access a Service Incentive Payment from Medicare Australia (the body responsible for administering Medicare) for providing the 3-step process.

3. Focused Psychological Strategies: This component promotes evidence-based focused psychological strategies, namely psycho-education, cognitive behavioural therapy and interpersonal therapy. These strategies are normally delivered by general practitioners in planned sessions, each lasting a minimum of 30 minutes. General practitioners who have completed Level 2 Training can bill Medicare Australia against specific Medicare item numbers which have been created to recompense them for their time in delivering focused psychological strategies.

4. Access to Allied Psychological Services: Through this component, general practitioners who have completed Level 1 Training are able to refer consumers to allied health professionals (e.g., psychologists, social workers) for the same focused psychological strategies described above. The allied health professionals are contracted to or employed by Divisions of General Practice through Access to Allied Psychological Services projects.

5. Access to Psychiatrist Support: This component enables psychiatrists to be reimbursed for participating in case conferences with general practitioners and others, and provides access to patient management advice to general practitioners from psychiatrists through a GP Psych Support service.

By the beginning of 2006, 4,467 general practitioners had completed Level 1 Training, and 902 had completed Level 2 Training. General practitioners had completed 48,736 3 Step Mental Health Processes and delivered 59,996 sessions of Focused Psychological Strategies. One hundred and eight Access to Allied Psychological Services projects had been funded, enabling 2,980 GPs to refer 26,444 patients to 1,040 allied health professionals.

Source: Adapted from Pirkis et al [37]