From 1 January 2012, GPs can refer Aboriginal patients with a diagnosable mental health disorder to Vanessa at Weave. Patients of all ages, who identify as Aboriginal, are eligible to access these services at no cost. Referrals are made as per usual arrangements via contacting CSGPN administration to obtain a unique ATAPS number, this entitles a patient to up to 6 individual/group services per referral with a maximum of 12 individual and 12 group sessions available per calendar year.

We are also working closely with our Closing the Gap team through this arrangement to assist individuals who do not currently have a GP to access culturally appropriate primary healthcare services.

GPs who are not yet registered for ATAPS are still able to do so by completing an induction (practice visit) with Mano (ATAPS project officer). To arrange a practice visit, contact Mano on 8752 4907.

There a number of Mental Health Skills Training (MHST) activities available to GPs, as well as a Focussed Psychological Skills (FPS) training course and a FPS-CPD (former Level 2 ongoing) course.

BDI_Randwick_Workshops_-_Feb_to_June_2012.pdf

For further information on the Black Dog Institute’s training calendar and programs on offer please refer to their website. If you have specific queries regarding their workshops please contact their Education Project Officer .(JavaScript must be enabled to view this email address) on 9382 8518

Further information regarding Postnatal Depression including available support services and resources can be found by visiting some of these websites:

• BeyondBlue
• Gidget Foundation
• PANDA : Post and Antenatal Depression Association Inc

ANSC information regarding Perinatal Mental Health Services and resources can be found by accessing the following information:

• SLHD Perinatal Mental Health Referral Flowchart
• SLHD Psychosocial Referral Form (June 2011):to ensure referral is received phone PMH 9515 5873 or GP Liaison Midwife 0425 230 662
• Edinburgh Depression Scale - Assessment of Perinatal Depressive Illness
• Access To Allied Professional Services (ATAPS) overview : Referral to Perinatal Depression Stream
• Local Perinatal Mental Health Referral Contacts
• St John of God Hospital: Mental Health Services: Mother and baby unit

The Department of Health and Ageing has developed fact sheets outlining these changes for both GPs and Allied Mental Health Professionals utilising the Better Access Inititative.

The factsheet for GPs outlines the changes to MBS item numbers based on both time spent developing plan and level of mental health skills training undertaken by the GP.
FACT_SHEET_-_Changes_to_rebates_for_GP_Mental_Health_Treatment_Plans2011.10_.28_.pdf

The factsheet for Allied Mental Health Professionals outlines the changes to sessions available per calendar year for patients referred by their GP or psychiatrist under a Mental Health Treatment Plan from 1 Novemebr 2011.
FACT_SHEET_-_Allied_mental_health_services_2011.10_.28_.pdf

Please note: Patients who have already received 10 MBS rebated sessions this calendar year under a Mental Health Treatment Plan will not be eligible for further rebated sessions (after 1 November 2011) until 1 January 2012.

In this week’s ‘Friday Facts’ the RACGP has released the below statement:
“The Mental Health Senate Inquiry will release its findings report next Friday, 21 October, regarding the proposed cuts to the Better Access program – cuts that will affect an estimated 1 million patients per annum. The College is currently reviewing a number of alternative funding models for practices to consider, should the College’s strong advice presented in front of the Senate Standing Committee on Community Affairs in August 2011 not be reflected in the soon-to-be released report. Alternative funding models will be published in next week’s edition of Fridayfacts.”

The proposed cuts refer to the reduced rebate for MBS Items 2702, 2710, 2712 and 2713. The Department of Health and Ageing is proposing to use the savings from this cut to fund ‘Flexible Care Packaes’ or ‘Care Coordination’ roles from 2011-12 financial year.

CSGPN will keep GPs updated on the outcome of the Senate Inquiry and any changes to MBS Items for Mental Health care by general practitioners.

The Black Dog Institute’s ‘The ABC of CBT: Skills for GPs’ event has been cancelled.

Lifeline has previously been unable to reach people in the deaf community with the traditional phone based crisis support service.  “The online trial is reaching new people never before communicated with. It’s stories like this that make the online trial a success, especially when the young person expresses such gratitude to us for diversifying into this medium.”

Lifeline have seen great demand for this online based service, particularly with the under 35 age group accounting for 83% of all contacts.

The trial has surpassed all expectations and Lifeline are pleased to announce that the trial is being extended until the 31st of August 2011 thanks to funding from the Department of Health & Ageing.

If you or someone you know is experiencing a crisis, call Lifeline on 13 11 14 or access their online chat service from 8pm (AEST) to midnight everyday.

The program - ‘Beyond babyblues: Detecting and managing perinatal mental health disorders in primary care’ - is the first of its kind in Australia and will provide health professionals - including midwives, GPs, obstetricians and maternal, child and family health care workers - with extra training and skills to understand, detect, treat and manage mental health conditions.

On completion of the advanced six-hour program, GPs will receive a mental health skills training qualification from the General Practice Mental Health Standards Collaboration (GPMHSC) and other health professionals will receive relevant recognition from their professional bodies.

To find out more about the online training, visit www.thinkgp.com.au/beyondblue

To find out more about depression, anxiety and related conditions during the perinatal period, visit:
beyondblue or www.justspeakup.com.au or call the beyondblue info line on 1300 22 4636.

The Infant Child Adolescent Mental Health Service (ICAMHS) including School Link have a brand new website.

The website includes:

• Information about Sydney and South Western Sydney Infant Child Adolescent Mental Health Services (ICAMHS) including referral criteria and how to make a referral
• Health programs supporting the mental health and wellbeing of children and young people
• The School-Link Newsletter
• Links to other mental health services for children and adolescents
• Other useful websites eg Beyond Blue, Reach Out
• Information for families and carers

The following items were removed from PBS listing (effective 1st April):
Zuclopenthixol decanoate (Clopixol® depot 200mg/mL)
Flupenthixol decanoate (Fluanxol® depot 20mg/mL & 40mg/2mL)
Note: The flupenthixol decanoate concentrated depot (100mg/mL) is still PBS listed.

These items are long acting injections for the treatment of psychosis.

Lundbeck Australia, the supplier, has advised that this is a result of ongoing pricing negotiations and likely to be a temporary arrangement.

The deletion of PBS listing will have significant impact on patients who currently obtain these depots from their local pharmacy and may not have the means or the inclination to pay private prescription prices. Private prescription pricing may vary between pharmacies however is approximately $30 for zuclopenthixol decanoate (Clopixol® depot) x 5 ampoules.

Many of the patients who have these medications have them administered at the local CHC and we are developing systems to ensure patients continue to receive this medication.

Some patients may receive this medication through their GP. It is important for patients who are prescribed this medication to continue to have it. The Sydney and Sydney South West LHN are prepared to help resolve any issues. For example if the barrier is that the patient will not pay then the LHN can be contacted and we may provide a supply of the medication to the GP.

Please contact Paul Clenaghan on 9378 1209 for any problems in the Central Sydney GP Network.

The beyondblue Clinical Practice Guidelines for women in the perinatal period (during pregnancy and the first year following birth) have been approved by the National Health and Medical Research Council (NHMRC) and are now available.

The Clinical Practice Guidelines draw on the latest high-quality research evidence to provide recommendations and good practice points for health professionals to identify, treat and manage depression, anxiety and related disorders in pregnant women and new mothers.

The Guidelines were prepared by an expert advisory group comprising mental health professionals, people who have experienced perinatal depression and related disorders – and carers.
The Draft Guidelines were released in 2010 for a two-month public consultation period during which submissions were accepted, reviewed and later, incorporated into the final Guidelines which were submitted to the NHMRC for its approval.

The Guidelines are an Australian first and will assist all health professionals working with women – midwives, GPs, obstetricians and maternal, child and family health care workers – to identify, manage and treat women with depression, anxiety, bipolar disorder and puerperal psychosis. 

Research shows women are more at risk of developing mental health disorders during the perinatal period than at any other time in their lives.  Up to 9 per cent of women will experience depression during pregnancy and almost 16 per cent will experience depression in the postnatal period. Early detection and appropriate treatment greatly reduces the risks not only for the mother, but for her baby and other family members.

Health professionals, women and their families will now be informed by quality research about the most effective treatments including which medications are safe to use during pregnancy and breastfeeding.

The development and application of the Perinatal Clinical Practice Guidelines is an integral part in the implementation of the National Perinatal Depression Initiative which has been allocated $85 million in funding by the Federal, State and Territory Governments.

Copies of the Guidelines can be downloaded FREE or ordered at beyondblue – or by calling the beyondblue info line 1300 22 4636. Summary documents for health professionals are in development.

The Australian Psychological Society (APS) has put together the attached brief document, following advice from Medicare Australia, in response to a series of questions to clarify issues raised by members who had undergone a Medicare Compliance Audit.

The information is also useful for GPs, to ensure the correct documentation is forwarded to allied mental health professionals, as well as received from them.

medicare-audit-update-feb-2010.pdf

At its March 2010 meeting, the Pharmaceutical Benefits Advisory Committee (PBAC) recommended an extension to the listing of nicotine patches through the Pharmaceutical Benefits Scheme (PBS) as an aid to smoking cessation.  Previously, nicotine replacement therapy was only available to indigenous patients.

From 1 February 2011, the listing for nicotine patches (Nicorette®, Nicabate P® and Nicotinell®) has been extended to include all eligible individuals (general and concessional patients). 

Further information regarding this change can be found on the PBS website

The portal provide information, advice and online training for health professionals as well as the community, around improving the physical health of those who use a mental health service.

The web portal can be accessed at: www.cadre.com.au/nsw_health

The Missenden Psychiatric Unit at Royal Prince Alfred Hospital has relocated with 38 Beds, to:

Level 6
the QE II Building
57-59 Missenden Road
Camperdown NSW 2050

Telephone numbers remain the same, contact 9515 6111 for assistance.

General practices, organisations and/or individuals are invited to submit an expression of interest to develop a medical “General Practice Service for Mental Health clients” at either Redfern Health Centre, Croydon Health Centre or both sites.

EOI_Submission_Guidelines__Forms.pdf

The closing date for submission is 5pm Friday 24 September 2010.

Around one in five people, usually women, who develop the eating disorder would die as a result, says Associate Professor Susan Byrne from the University of WA’s School of Psychology.

She said many treatments had emerged over the years, from different models of counselling and therapy along with acute hospital care, though there was little evidence to show which approach was best.

“Currently, there are a whole range of treatments and we don’t have any evidence that one is any better than the other,” Dr Byrne said on Friday.

“... We’re really trying to gather some evidence so we can say to people, with confidence, that we have evidence that this or that treatment is helpful.”

Dr Byrne is seeking around 200 adult volunteers who have an eating disorder and who are based in Sydney, Adelaide or Perth.

Participants will receive ten months of free treatment - in one of three different front-line therapies developed independently and used by some to tackle anorexia in different parts of the world.

The research will compare Enhanced Cognitive Behaviour Therapy, developed at Oxford University; Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), developed at London’s Maudsley Hospital; and New Zealand’s Specialist Support Clinical Management for Anorexia Nervosa.

Dr Byrne said each treatment focused on restoring a normal eating pattern and healthy weight “so that the person with anorexia nervosa can become physically and mentally well again”.

Fifteen per cent of Australian women will suffer from an eating disorder during their lifetime, with around four per cent of these cases classed as anorexia.

The cause remains unknown though anorexia has the highest mortality rate of any psychiatric disorder, with 15 to 20 per cent of sufferers dying after 15 years.

“It’s not really are rare as people tend to think,” Dr Byrne said.

Those seeking to join the research can call the UWA’s School of Psychology on 08 6488 7428 or email: treatmenttrial@psy.uwa.edu.au

On Wednesday 25 August a workshop will be held at Balmain Town Hall from 6:30pm to explore a range of different mental health services that could be offered at Callan Park.

Mental Health Master Plan Workshop

If you are unable to attend the workshop, comments on the website regarding the newer proposals put forward are very welcome. A document outlining these proposals should be available after the workshop next Wednesday.

The locations of ten new headspace centres have been announced by the Federal Government and headspace. The new centres are part of the $78 million funding package for headspace announced in the May Federal Budget. The first raft of those centres will be located in areas of high need.

New headspace sites

Release of the work and your mental health brochure for General Practitioners

For more information on Sexual Health, please contact the following staff:

Vijay Ramanathan Phone: 8752 4915
Julie McLean-Murray Phone: 8752 4905

Download

• Gay friendly GPs

Developed by Sydney South West Area Mental Health Service, consumer medication brochure series on Antipsychotic Medications, Benzodiazepine, Bipolar, Clozapine and Depression is now available on our website as PDF’s for you to download.

Consumer Medication Brochure Series

• CMB Antipsychotic Medications
• CMB Benzodiazepine
• CMB Bipolar
• CMB Clozapine
• CMB Depression

For more information regarding our Mental Health project, please contact Karen Frost on 8752 4910.

New Australian Alcohol Guidelines - the National Health and Medical Research Council’s (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking Alcohol were released on 6 March 2009.
The key changes include the following revised guidelines:

Guideline 1

For healthy men and women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury.

Guideline 2

For healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol related injury arising from that occasion.

Guideline 3

3A Parents and carers should be advised that children under 15 years of age are at the greatest risk of harm from drinking and that for this age group, not drinking alcohol is especially important.
3B For young people aged 15–17 years the safest option is to delay the initiation of drinking for as long as possible.

Guideline 4

4A For women who are pregnant or planning a pregnancy, not drinking is the safest option. 
4B For women who are breastfeeding, not drinking is the safest option.

Alcohol has a complex role in Australian society. Most Australians drink alcohol, generally for enjoyment, relaxation and sociability, and do so at levels that cause few adverse effects. However, a substantial proportion of people drink at levels that increase their risk of alcohol-related harm. For some, alcohol is a cause of significant ill health and hardship. In many countries, including Australia, alcohol is responsible for a considerable burden of death, disease and injury. Alcohol-related harm to health is not limited to drinkers but also affects families, bystanders and the broader community.

NHMRC intends Australian Guidelines to Reduce Health Risks from Drinking Alcohol to establish the evidence base for future policies and community materials on reducing the health risks that arise from drinking alcohol. It is about helping you to help your patients reduce the risks to their health from drinking alcohol.

Of course, how much your patients drink is their choice. But the NHMRC hope these guidelines will help you to help your patients make an informed choice and also help health agencies guide the community in reducing health risks. Click on the following links to view and download the indicated resources:

• Download the Australian Guidelines to Reduce Health Risks from Drinking Alcohol
• Summary of the Guidelines
• Alcohol FAQ
• The Australian standard drink

Alternatively you can view and download the new guidelines, including a summary, FAQs and standard drink guide by clicking on the following link at:
http://www.nhmrc.gov.au/your_health/healthy/alcohol/index.htm

Information and resources relating to the new guidelines will soon be available on www.alcohol.gov.au from late April 2009.

For more information contact:

Project Officer: Karen Frost
Phone: 8752 4910

Mood disorders in General Practice - as simple as DSM, SSRI & CBT?

The webcast
In the past decade mental health, and depression in particular, has received a great deal of attention both in the general and medical media. Awareness of depression has markedly increased, attempts have been made to reduce its stigma, and a lot of effort has gone into educating GPs.

No-one would argue that this has not been a positive development. However it has lead on occasions to an oversimplification, where all bad moods are depression, and depression always responds to evidence based treatment with CBT & an SSRI.

Clinical reality in general practice is rather different. We see a wide range of low moods, only some of which are unipolar depression. Many belong to other diagnoses, and many, despite being very significant, struggle to fit neatly any single DSM category. General practice is messy and our patients rarely conform to the neat case studies of typical education modules. And treatments may be evidence based, but the patients to whom we offer them are rarely the same as those carefully selected folk from whom the evidence was gathered.

This talk tries to step back a little and look first at normal mood and its adaptive function, and then go on to take an honest look at the diverse range of mood presentations in GP. In no sense didactic, it is one particular GP’s reflections on how he approaches the manifold uncertainties around treating mood dysfunction. It touches on the difference between the cross sectional, phenomenologically driven approach of some specialist practitioners and the more longitudinal, formulation based approach often found in general practice. It touches on lifestyle, ‘second line’ pharmacological treatments and when to move beyond CBT & explore the meaning of depressive symptoms.

The presenter
Dr Simon Cowap MBBS (Hons) FRACGP is a GP with a long interest in mental health. He is currently practicing at the Brain & Mind Research Institute (BMRI), Camperdown, headspace (youth mental health initiative) in Campbelltown, and in private mental health focused practice in Glebe. He is a level II mental health accredited practitioner, and has both attended and helped design and deliver a number of mental health education initiatives for general practitioners. He has written on general and mental health issues for publications including the Australian Family Physician, Medical Observer, the Australian newspaper and a variety of internet sites. He is currently assisting in the development of the BMRI’s post graduate education programme for GPs intended to commence in 2010. He is interested in the collaborative care of mental health patients and the unique perspective GPs bring to the mental health team.

Accessing and participating in the broadcast
The live broadcast will be a presentation to a small studio audience. The talk will last approximately 30 to 40 mins with 20 minutes for questions. You will be able to watch the live webcast at home on your computer, and the program will allow you to type in questions which the speaker can address during the question time. Access is free to ACPM members and members of the Central Sydney GP Network - co-sponsors of this webcast.

Instructions for viewing
This event is free to financial members of CSGPN, details can be viewed by logging in to the Members section of this website or contact us for further details.

If you are not able to view the live webcast you will be able to access it a few weeks later on the web site by going through the above steps.

For further information please contact: 
Dr Howard Gwynne
email: howard@aya.yale.edu
ph: 0402 827 156

The Melancholia Study Team is pictured (from left to right): David Gilfillan, Tania Perich, Iain MacMillan, Bianca Blanch, Gordon Parker, Vijaya Manicavasagar, Dusan Hadzi-Pavlovic, Alex Apler.

The Black Dog Institute is offering immediate free specialist psychiatric and psychological consultations for up to 300 people experiencing melancholic depression as an inducement to participate in a 12-week trial. The reality is that currently people are waiting up to three to six months when they are referred to see a mood disorder specialist, according to the Black Dog Institute. The “queue jumping” trial announced 17 February 2009, will allow people to receive free treatment and make a valuable contribution to a study that is designed to measure best treatments for melancholic depression. Professor Parker, Executive Director of the Black Dog Institute, has also given an undertaking that if the participants have not improved following the 12-week trial, the Institute will offer ongoing free management for their condition.

Black Dog Institute
Hospital Road
Prince of Wales Hospital
Randwick NSW 2031

Business Hours: MON-FRI 9am-5pm
Reception/Deliveries/General Information: 9382 4530
Community/Consumer Enquiries: 9382 4523
Clinics: 9382 2991
Fax: 9382 8208
Email: blackdog@unsw.edu.au

Central Sydney GPs will shortly be able to refer eligible patients for free psychological therapy to our selected Access to Allied Psychological Services (ATAPS) providers with expertise in PND
Recent studies show that 1 in 7 women in Australia experience postnatal depression. The aims are to provide better care, support and treatment for expectant mothers, new mothers and their families.

Our current ATAPS and Antenatal Shared Care projects will be combining forces to run this project in our area. Key activities of this project include the following:

• establishing linkages and relationships with local child and maternal health services and primary mental health care services to ensure that women experiencing perinatal depression and their families have the necessary resources available to them;
• as appropriate, promoting the use of other pathways to care for women experiencing perinatal depression and their families;
• ensuring that women experiencing perinatal depression and their families are able to receive treatment under ATAPS; and
• promoting and disseminating materials and resources to GPs and allied health professionals to support professional practice in respect of perinatal depression treatment and support;

Discussions are being held with the key SSWAHS service providers as well as Karitane and Tresillian on how best to ensure this program meets the needs of the most at risk women.

Karen Frost (ATAPS) and Dianne Deschamps (ANSC) are interested in speaking to GPs who care for large numbers of women from Culturally and Linguistically Diverse Backgrounds to see how this initiative would assist the women you care for.

Do not hesitate to contact either Karen Frost on 8752 4910 or Dianne Deschamps on 8752 4923 for further information or advice regarding this program.

www.psychevisual.com

The psyche in health and illness is an innovative approach to adult learning in the fields of psychology, psychiatry and mental health care. Users will find papers and multimedia presentations easy to access and are given a wide range of material of value to professionals and to the interested public. The access to the content of this site is free to members of Central Sydney GP Network and the Australian College of Psychological Medicine, otherwise access is by subscription, on a pay per view or pay to download basis.

The site is a valuable aid for people in professional training and is highly informative for consumers of mental health services. The site has interactive capabilities so subscribers will have the possibility of occasions of direct interaction with speakers. Many of our speakers are leaders in the field and we provide information about all speakers and their publications which can be ordered via this site.

For further information, contact:
Project Officer: Karen Frost
Phone: 8752 4910

NSW Mental Health Act 2007 involuntary schedule of a mental health patient form. Please click on the following links for Schedule 1 - medical certificate as to examination or observation of person:

• Medical Director template
• Best Practice template
• How to import templates from CSGPN website Handout : Medical Director or Best Practice

For further information please contact:
Project Officer: Karen Frost
Phone: 8752 4910