Portal for General Practitioners
Portal for General Practitioners
Referral Procedures
> Assessment
> Preparation of a GP Mental Health Care Plan
> Differentiated Services
> What does a Psychologist do?
> What differentiates the Family Challenge Psychology Clinic?
> Common Questions
There are three (3) essential steps in developing a Mental Health Care Plan* and referring a client for psychological services:
(a) formally assess the patient and develop a plan;
(b) refer to an appropriately qualified/registered psychologist;
(c) review and provide ongoing management as required.
*Before developing a Mental Health Care Plan, General Practitioners must ensure that patient (or where appropriate, the patient's carer) completely understand the steps involved in providing such a service, and patient agreement to proceed is recorded.
Assessment:
An assessment of a patient must include:
- Record the relevant history (biological, psychological, social) of the patient, including any presenting problems;
- Conduct a mental state examination;
- Evaluate whether any associated risks exist (i.e., co-morbidity);
- Make a diagnosis and/or conceptual formulation; and
- Administer an evaluation/assessment tool (e.g., questionnaire), except where it deemed clinically inappropriate**.
**The choice of evaluation/assessment tools is at the discretion of the referring doctor. General Practitioner using such tools should be familiar with their appropriate clinical use, and if not, should seek appropriate advice. Specific evaluation/assessment tools may be differentiated by age, culture, and pathology. For a list of recommended tools, see Diagnostic Assessment Tools.
Assessing a patient can be conducted independently to the development of a Mental Health Care Plan or it can be conducted in the same visits (however, please note that sufficient time is required to completely this process properly). Where the assessment and Mental Health Care Plan development are conducted across two different consultations, they are part of the same service and should be included under item 2710.
Preparation of a GP Mental Health Care Plan
Preparation of a Mental Health Care Plan must include:
- A discussion detailing assessment outcomes with the patient, including formulated diagnosis;
- Identification and discussion of referral and treatment options with the patient, including appropriate support services;
- Establish key therapeutic objectives with the patient and identify the role of the patient in achieving them;
- Provision of basic psycho-education (how the relationship between thoughts, feelings and physiology may impact upon daily functioning);
- If appropriate, develop a plan for crisis intervention and/or relapse prevention (identifying high risk situations and contingency plans for safety);
- Facilitate referral to an appropriately qualified and registered psychologist and outline basic treatment expectations. Where necessary, provide appropriate support, review, and follow-up services*;
- Document in the patient's Mental Health Care Plan any results of assessment, specific patient needs, therapeutic objectives and patient responsibilities towards these. Referral details for treatment and review date should also be documented**.
INFORMATION SOURCE FOR REFERRAL PROCEDURES:
Australian Government Department of Health and Ageing; Medicare Australia; Divisions of General Practice (Australian General Practice Network); Royal Australian College of General Practitioners; The Australian Psychological Society; Family Challenge Psychology Clinic.
*Following the sixth consultation with a psychologist, a review should be conducted for continuation or cessation of services. A recommendation from the patient's psychologist is a sufficient review for continuation of services (the patient is NOT required to undergo a review in person by their referring General Practitioner). A formal review and evaluation in person should be conducted by the referring General Practitioner at the conclusion of psychology services.
**Once a Mental Health Care Plan has been completed and claimed on Medicare, a patient is eligible for access to up to twelve Medicare rebates per calendar year for psychology services (with provision for an extra six rebates [totalling 18] under exceptional circumstances).
Referrals to General and Specialist Psychologists under Medicare's new Mental Health Care initiative are available for patients with 'mental disorders' (including patients with chronic or non-chronic disorders).
Clinically diagnosable mental disorders are characterised by emotional, cognitive and behavioural symptoms that adversely impact upon a person's daily functioning, social interactions, and decision-making processes (Refer to the World Health Organisation 1996, Diagnostic & Management Guidelines for Mental Disorders in Primary Care: ICD-10 Chapter V Primary Care Version).
Mental disorders include:
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Differentiated Services
Public vs Private Mental Health Services
Psychology Medicare rebates under the new Better Access to Mental Health Care initiative apply to services provided by General and Specialist Psychologists in Private Practice. Rebates are not available for services provided by any Commonwealth or State-funded programs*.
*Where an exemption under subsection 19(2) of the Health Insurance Act 1973 has been granted to an Aboriginal Community Controlled Health Services or State/Territory Government health clinic, these items can be claimed for services provided by eligible allied health professionals salaried by, or contracted to, the service as long as all requirements of the items are met, including registration with Medicare Australia.
General vs Specialist Psychologist Services
'General' and 'Specialist Clinical' Psychologists differ in:
(a) the type of professional experience/qualification;
(b) the services they are eligible to offer; and
(c) the level of rebate offered by Medicare.
'General' Psychologists - defined as having a minimum four years training (registered with the State Psychologists Board and Medicare Australia), may deliver approved Focused Psychological Strategies (FPS) according to their self-assessed knowledge, skills, experience, and competence. Patients attending consultations with a 'General' Psychologist are eligible to receive a Medicare rebate of $75 per consultation (>50mins).
'Specialist Clinical' Psychologists - defined as having specific training and qualifications (e.g., Clinical Masters and/or Ph.D.) in Clinical Psychology and/ or eligibility for membership of the Australian Psychological Society's College of Clinical Psychologists. Specialist Clinical Psychologists may provide clinical and diagnostic assessment of mental health concerns, psycho-education, and psychological therapies (including, but not limited to cognitive behaviour, interpersonal, and evidence-based therapies according to clinical relevance).
Patients attending consultations with Specialist Clinical Psychologists are eligible to receive a Medicare rebate of $110 per consultation (>50mins).
What does a Psychologist do?
Although both psychologists and psychiatrists work in the mental health arena, the two professions differ in:
- the type of professional education/qualification;
- the services they offer; and
- the use of medication.
Psychologists undergo at least six years formal study and field experience and often specialise in various disciplines (e.g., clinical and occupational). Doctors of Clinical Psychology receive up to nine years of formal/specialist training in evidence-based practice. The psychology profession is largely concerned with understanding and influencing human behaviour, thought, and emotion.
Psychologists help patients with mental disorders find ways to function better in life. Psychologists do not prescribe medication; however often work closely with prescribing Psychiatrists and General Practitioners. Psychologists also help mentally healthy people achieve optimum performance (e.g., in areas of sport, career, and relationship).
What differentiates Family Challenge?
Family Challenge is a Specialist Psychology Clinic offering assessment, early intervention/prevention, and treatment services to children, adolescents, and their families. A new adult service is also now in operation.
Family Challenge Psychology Clinic selectively employs master practitioners (recruited from around Australia) according to their vast experience, qualifications, reputation, and specialist expertise (Clinical, Neurophysiology, Educational Psychology disciplines). As a condition of employment with Family Challenge, each Specialist Clinical Psychologist has completed a minimum of Postgraduate Honours, Masters and/or Doctorate (Ph.D.) in Clinical Psychology.
Family Challenge Psychology Clinic offers comprehensive assessment, early intervention/prevention, resilience building, and treatment services. Family Challenge aims to address and resolve issues, not talk about them! 'Intervention' is all about invoking immediate and sustainable change. The specific methodologies utilised by Family Challenge Psychologists to achieve desired change are derived from scientific research, family centred ethical principles, and clinical innovation.
Family Challenge Psychology Clinic is a professional, not-for-profit, nongovernment organisation. All proceeds from clinical operations are dedicated to the Family Challenge Charitable Trust (a nationally registered Mental Health Charity with DGR status) for the promotion of mental health and stronger families locally and in the developing world.
Common questions for General Practitioners
Can a patient choose their own Psychologist?
General Practitioners may allow their patients to nominate or request a specific psychologist so long as the psychologist meets the minimum requirements as a Medicare Provider. Patients already seeing a psychologists may also receive a referral to the same Psychologist in order to claim a Medicare rebate.
How many psychology consultations are patients entitled to?
Patients can generally receive up to twelve individual psychology consultations in a calendar year. Under exceptional circumstances, provisions exist for patients to be reassessed and referred for a further six consultations (totalling 18 in a calendar year). In addition, patients are eligible to receive a further twelve group therapy services in a calendar year where such services are available and seen as appropriate by the psychologist.
What rebates are available for Family Challenge Services?
Patients referred on a GP Mental Health Plan are eligible to claim a rebate of up to $110 from Medicare. If claiming on Private Health Cover, the account is itemised allowing families to claim 30-100% of the consultation fee (depending on the Policy holder's level of 'Extras' cover, duration of consultation, and number of family members engaging therapy).
What's required before patients can claim a Medicare rebate?
Before patients can claim a rebate from Medicare for psychology services, the referring General Practitioner (or other relevant medical practitioner) is required to have lodged a Mental Health Care Plan / referral item with Medicare Australia.
Do referring doctors require a specific form to refer patients?
At present, there are no established forms that General Practitioners must use when referring a patient to a psychologist. However, referring practitioners should provide:
(a) a referral letter
(b) a copy of the Mental Health Care Plan (with patient's permission).
INFORMATION SOURCE for Psychology & Medicare: Australian Government Department of Health and Ageing; Medicare Australia; Divisions of General Practice (Australian General Practice Network); Royal Australian College of General Practitioners; The Australian Psychological Society; Family Challenge Psychology Clinic.
