GP Mental Health Treatment Plans

Last updated 13.02.13

 

Index

 

Definition

-  Development of mental health treatment plan between a patient & their GP

-  Patient with a mental health problem for greater than 6 months & requiring mental health professionals for their care

-  Dementia, delerium, smoking & mental retardation are not regarded as mental health problems in this context

-  Patient must be living in the community, if in aged care use Chronic Disease Management plans (unless privately funded then can access)

 

Features

-  GP Management Plan for mental health issues

-  Patient must have claimed rebate for or already lodged a claim for a GP Mental Health Treatment Plan before they can access the rebates for the allied services

-  GP should be aware of available local resources/services

-  Provides medicare rebate for

-  6 sessions in the intial treatment (per year)

-   Social worker (Psych trained)

-   Occupational therapist (Psych trained)

-   Clinical psychologist

-   Psychologists

-   GP (Psych trained)

-   Can re-refer if needed for an additional 4 sessions (10 total per year)

-   16 sessions (per year) if exceptional circumstances

-  Plus 10 sessions per year of group services

-   Clinical psychologist

-   Allied mental health professional

-  One plan allowed per 12 month period

-  MBS Items

-  GP consult of patient under a plan or a mental health issue >20min: 2713 $70.30

-   Same as GP Consult >20min: item 36 $70.30

-  Development of Plan

-   GP without mental health training

-   20-40min: 2700 $70.30

-   >40min: 2701 $103.50

-   GP with mental health training

-   20-40min: 2715 $89.25

-   >40min: 2717 $131.45

-  Review of Plan: 2712 $70.30

 

Procedure

-  If patient has existing plan attempt to contact existing plan & review

-  If unsure can contact Medicare 132 150 to see if item numbers already billed

-  Assess support network for patient

-  Offer patient to bring along: carer, friend, partner, parent, etc.

-   Someone else to listen

-   Can remind patient what was said

-   Assist patient to maintain plan

-   If present try to engage support person

-  Detailed assessment & Diagnosis of mental health issue

-  Determine agreement of patient for plan

-  Assessment

-   Mental state exam

-   Risk to self & others

-  Diagnosis

-  Client needs

-  Goals

-   Including outcome measurement tools

-   AUDIT: EtOH dependance

-   K10: Depression

-   PHQ 9: Depression

-   PHQ 15: Somatisation

-   DASS21: Depression, Anxiety

-   SF12

-   HoNOS

-   GAD 7: Anxiety

-  Actions

-   Crisis management

-   Prevention strategies for relapse

-  Referrals

-  Treatments/services

-  Review dates

-  Review patient past Hx

-  Physcial illnesses which may be contributing

-   Ix as appropriate

-  Previous Dx & Mx

-  Confirm medications

-  Old & current: why commenced, changed, doses

-  Compliance/variations of current medications

-  Indentify barriers to access: $, transport, co-operation, wait times

-  Assist as able with making appointments

-  Encourage patient to book for appointments well in advance with reminders if possible

-  Print copy for patient

-  Go through in detail

-  Amend as necessary

-  GP & patient to sign

-  Referral as necessary

-  At end of course of treatment (sessions as above) referred professionals should provide a written report to the GP detailing assessment, treatment & recommendations

-  Arrange follow up

-  Ideally to see same GP each time

-  Review in 1-6 months post initiation

-  Repeat review 3 months later

-  Yearly review (<12 months) for renewal of plan

 

 

 

References

 

DoH: www.health.gov.au/internet/main/publishing.nsf/content/pacd-gp-mental-health-care-pdf-qa

& www.health.gov.au/internet/main/publishing.nsf/Content/pacd-gp-mental-health-care-pdf-factsheet

Beyond Blue: Outcome Measures for Health Professionals: www.beyondblue.org.au/index.aspx?link_id=103.1162&print=true