State & territory jurisdictional reports: Activity relating to mental health reform prior to the implementation of the Fourth National Mental Health Plan

3. Improve coordination between primary care and specialist mental health services in the community to enhance consumer choice and facilitate 'wrap-around' service provision

Page last updated: December 2010

Department of Health and Ageing

  • The Access to Allied Psychological Services initiative (ATAPS) facilitates links between primary and specialist mental health care.
    ATAPS is an Australian Government mental health initiative which funds the provision of short term psychology services for people with mental disorders through fundholding arrangements administered by Divisions of General Practice. Divisions are able to adopt a model that best suits their local arrangements.
    ATAPS enables GPs to refer consumers with high prevalence mental health disorders to allied health professionals for six sessions of evidence based mental health care. An option for a further six sessions exists (and up to an additional six sessions in exceptional circumstances), pending a mental health review by the referring GP.
    While any consumer with a mental disorder would generally be eligible for ATAPS, it is intended to target services to those individuals requiring primary mental health care who are not likely to be able to have their needs met through Medicare based mental health services (Better Access).
    The Department encourages a high level of communication between referring and treating providers. A team based approach to care involving the GP in care coordination is often crucial to effective whole-of-person care.
    The Department recognises the need for close linkages between GPs, allied health professionals and specialist mental health services in the community and is encouraging further development of linkages. This will become more important when the new Flexible Care Packages for people with severe mental illnesses become operational under ATAPS late in the 2010-11 financial year. Top of page
  • Better Access initiative
    The Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) initiative includes a range of Medicare rebateable services for eligible people with a diagnosed mental disorder, including psychological strategies provided by GPs, psychiatrists, clinical psychologists, registered psychologists and other suitably qualified mental health providers.
    Psychiatrists, paediatricians and general practitioners can refer patients for intensive, short-term Medicare subsidised mental health services.
    Medicare rebates are available for eligible people for up to 12 individual and/or up to 12 group allied mental health services per calendar year. In exceptional circumstances an additional six individual services may be accessed.
    Mental health services that can be provided under the Better Access initiative include Psychological Therapy services provided by Medicare-eligible clinical psychologists, and Focused Psychological Strategies services provided by registered psychologists, and other suitably qualified mental health providers.
    The Better Access initiative encourages a collaborative approach to the provision of mental health services, with the GP responsible for developing a Mental Health Treatment Plan for their patient and referring them for psychological services. The GP retains the responsibility for the care and treatment of the patient and receives a report back from the allied mental health professional which includes an outline of the treatment provided; patient outcomes and recommendations on future management of the patient's disorder. This report allows the GP to review the patient and assess their progress and any further treatment needs.
  • Rural & Remote
    The Mental Health Services in Rural and Remote Areas (MHSRRA) Program provides funding for mental health professionals in communities that would otherwise have little or no access to mental health services. Organisations such as Divisions of General Practice, Aboriginal Medical Services and the Royal Flying Doctor Service are funded to deliver mental health services by appropriately trained mental health care workers, including psychologists, social workers, occupational therapists, mental health nurses, Aboriginal health workers and Aboriginal mental health workers. The GP has an active role in the care and management of the patients needs including referral of patients for services under the Program and liaison with the mental health professionals in implementing a suitable treatment plan. Top of page

Department of Families, Housing, Community Services and Indigenous Affairs

  • Targeted Community Care (mental health) Program assists people with mental illness, their carers and families to find appropriate support and facilitate access where necessary.
    • Personal Helpers and Mentors – one on one supports for people who cannot manage their daily activities or live independently because they have a severe mental illness. The PHaMs mainstream service model was adapted to recognise and promote spiritual, cultural, mental and physical healing for Indigenous Australians living with mental illness in remote communities. This Remote Service Model had the age restriction removed to allow younger people, especially those engaging in risk of taking behaviours to access the program.
    • Mental Health Respite – respite, education and support for carers of people with severe mental illness; and
    • Mental Health Community Based Services - supports families, young people (aged between 16 and 24 years) and carers affected by mental illness.
  • National Disability Agreement - As part of the National Disability Agreement, a National Framework for Service Planning and Access will be developed, focussing on providing a person centred approach to service delivery and to simplify access to specialist disability services.
  • National Compact: Working Together - One of the actions identified in the National Compact Commonwealth Action Plan is to:
    • act to improve opportunities for the Commonwealth Government and Third Sector Agencies to work together to better coordinate service delivery, particularly for marginalised and disadvantaged people (linked to the following National Compact priority action areas: 3: Recognise Sector diversity; 5: Reduce red tape; 7: Act on workforce issues; and, 8: Improve funding/procurement processes).
    The lead/reporting agencies identified for this action are FaHCSIA and the Department of Human Services with National Compact Across Government Working Group members to report their agency's ongoing achievements against this action. The expected outcome of this action is: Better coordinated service delivery, particularly for marginalised and disadvantaged people.
    Progress to date includes: In the week beginning 26 April 2010 - Community Links Projects are being coordinated by the Dept of Human Services. This is the beginning of the "roll out" of new arrangements to bring "wrap around services" models to 4 Centrelink offices and involving the participation of Community service organisations as partners. Top of page

Human services portfolio

  • Centrelink social workers provide crisis intervention in addition to counselling, support and referral services

Department of Veterans' Affairs

  • The VVCS – Veterans and Veterans Families Counselling Service provides counselling support to all Australian veterans, peacekeepers, their family members and eligible Australian Defence Force personnel. This service is free, confidential and provided by professionally qualified psychologists and social workers. VVCS has 15 centres across Australia and operates an after-hours counselling support and crisis assistance telephone service, Veterans Line.
  • VVCS has approximately 550 contracted providers who are qualified psychologists or social workers located in outer metropolitan and regional areas around Australia. Of these providers, 509 delivered 31,366 counselling sessions to 5,465 clients who were not able to access a VVCS centre.
  • VVCS is conducting a 12-month pilot using videoconferencing technology to provide counselling to veterans and their families who live in regions where access to a local mental health service is problematic or non-existent. This is aimed at improving access to community mental health services.

Department of Defence

  • The ADF and VVCS have an agreement for services to provide counselling support services to current serving personnel across all regions.
  • The mental health workforce will be enhanced by the full integration of health professionals, including social workers into the regional garrison health care delivery areas. This will allow the formation of multi-disciplinary teams in order to deliver evidence based care. There will also be further enhancement of the interaction with the Defence Community Organisation.