Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
Shopping Cart: ( empty )
You are here: Home > Journals > PY > PY08072
RESEARCH ARTICLE
Contents Vol 15(3)

Australian primary mental health care: improving access and outcomes

Justine R. Fletcher A D , Jane E. Pirkis A , Bridget Bassilios A , Fay Kohn A , Grant A. Blashki B and Philip M. Burgess C
+ Author Affiliations
- Author Affiliations

A Centre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Vic. 3010, Australia.

B Nossal Institute for Global Health, University of Melbourne, Vic. 3010, Australia.

C Queensland Centre for Mental Health Research, School of Population Health, University of Queensland, Level 3 Dawson House, The Park, Wacol, Qld 4076, Australia.

D Corresponding author. Email: justine.fletcher@unimelb.edu.au

Australian Journal of Primary Health 15(3) 244-253 https://doi.org/10.1071/PY08072
Published: 9 September 2009

Abstract

The progressive achievements over time of the Access to Allied Psychological Services (ATAPS) component of the Better Outcomes in Mental Health Care program are examined using a web-based, purpose-designed minimum dataset that collects provider-, consumer- and session-level data on the projects. Findings indicate that the ATAPS projects have established themselves over time as a cornerstone of mental health service provision in Australia. Despite the more recent introduction of the complementary Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule program, the ATAPS projects have continued, since 2001, to attract substantial numbers of general practitioners and allied health professionals and deliver services to significant numbers of consumers. The profile of consumers being referred to the projects is now very consistent, with the majority being women with high prevalence disorders who may have had difficulty accessing mental health care in the past. The nature of sessions being delivered through the projects has also reached a point of consistency, with the majority being individual-level, cognitive behavioural therapy-based sessions of around 1 h in length. The only variation in session delivery is related to the charging of a co-payment. There is good evidence that the projects are achieving positive outcomes for consumers.

Additional keywords: allied health, mental health reform, psychology.


Acknowledgements

This work was funded by the Australian Government Department of Health and Ageing, which also made available the Medicare Benefits Scheme data for the Better Access program. The authors would also like to express their gratitude to Strategic Data Pty Ltd for developing the minimum dataset and the Divisions of General Practice for managing the ATAPS projects.


References


Andrews G , Hall W , Teesson M , Henderson S (1999) ‘The mental health of Australians.’ (Commonwealth Department of Health and Aged Care: Canberra)

Andrews G, Sanderson K, Slade T, Issakidis C (2000) Why does the burden of disease persist? Relating the burden of anxiety and depression to effectiveness of treatment. Bulletin of the World Health Organization 78(4), 446–454.
| PubMed |  CAS | open url image1

Australian Bureau of Statistics (1998) ‘Mental health and wellbeing: profile of adults, Australia, 1997.’ (Australian Bureau of Statistics: Canberra)

Department of Health and Ageing (2006) ‘Better access to mental health care.’ (Commonwealth of Australia: Canberra)

Fletcher J , Pirkis J , Kohn F , Bassilios B , Blashki G , Burgess P (2007) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Tenth interim evaluation report – progressive achievements over time. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Fletcher J , Bassilios B , Pirkis J , Kohn F , Blashki G , Burgess P (2008) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Twelfth interim evaluation report – making an impact on the Australian mental health care landscape. Centre for Health Policy, Programs and Economics, School of Population Health, The University of Melbourne, Melbourne.

Hickie I, Groom G (2002) Primary care-led mental health service reform: An outline of the Better Outcomes in Mental Health Care initiative. Australasian Psychiatry 10, 376–382.
| Crossref | GoogleScholarGoogle Scholar | open url image1

Huibers MJH, Beurskens AJHM, Bleijenberg G, van Schayck CP (2007) Psychosocial interventions by general practitioners. Cochrane Database of Systematic Reviews (3), CD003494.
| Crossref | GoogleScholarGoogle Scholar | CAS | open url image1

Joint Consultative Committee on Psychiatry (1997) ‘Primary care psychiatry: the last frontier.’ (Australian Government Publishing Service: Canberra)

Kohn F , Morley B , Pirkis J , Blashki G , Burgess P (2005 a) Evaluating the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative: Fourth interim evaluation report. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Kohn F , Morley B , Pirkis J , Shandley K , Naccarella L , et al (2005 b) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Sixth interim evaluation report: progressive achievements over time. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Kohn F , Pirkis J , Bassilios B , Fletcher J , Morley B , et al (2007) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Eleventh interim evaluation report – utilisation of evaluation findings. Centre for Health Policy, Programs and Economics, School of Population Health, The University of Melbourne, Melbourne.

Lipsey MW , Wilson DB (2000) ‘Practical meta-analysis.’ (Sage: London)

Morley B , Kohn F , Pirkis J , Blashki G , Burgess P (2004) Evaluating the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative: Second interim evaluation report. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Morley B , Kohn F , Pirkis J , Blashki G , Burgess P (2005) Evaluating the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative: Third interim evaluation report: benefits and barriers associated with different models of service delivery. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Morley B , Kohn F , Naccarella L , Pirkis J , Blashki G , Burgess P (2006 a) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Seventh interim evaluation report – rural and urban projects: similarities and differences. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Morley B , Pirkis J , Sanderson K , Burgess P , Kohn F , et al (2006 b) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Eighth interim evaluation report – consumer outcomes: the impact of different models of psychological service provision. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Morley B, Pirkis J, Sanderson K, Burgess P, Kohn F, Naccarella L, Blashki G (2007) Better outcomes in mental health care: The impact of different models of psychological service provision on consumer outcomes. The Australian and New Zealand Journal of Psychiatry 41, 142–149.
| Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Moulding R , Blashki G , Gunn J , Mihalopolous C , Pirkis J , Naccarella L , Joubert L (2007) ‘Optimising the primary mental health care workforce: How can effective psychological treatments for common mental disorders best be delivered in primary care?’ (Australian Primary Health Care Research Institute: Canberra)

Naccarella L , Morley B , Pirkis J , Kohn F , Blashki G , Burgess P (2006) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Ninth interim evaluation report – demand management strategies. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Pirkis J , Blashki G , Headey A , Morley B , Kohn F (2003) Evaluating the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative: First interim evaluation report. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.

Pirkis J , Morley B , Kohn F , Blashki G , Burgess P (2005) Evaluating the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care Program: Fifth interim evaluation report – models of service delivery: profile and association with access. Program Evaluation Unit, School of Population Health, The University of Melbourne, Melbourne.