In Australia and other developed countries, mental health is one of the leading causes of nonfatal burden of disease and injury. It is estimated that mental health and behavioural health disorders affect about 25% of all people at some time during their lives and are present at any point in time in about 10% of the population (WHO: World Health Report 2001). In Australia, the Burden of Disease and Injury in Australia 2003 Report, identified that mental health disorders and neurological and sense disorders contributed to 13% of burden of disease and injury. Of these, anxiety and depression, alcohol abuse and personality disorders dominated the burden of mental health disorders. In contrast, cancers and cardiovascular diseases accounts for 19% and 18% of burden of disease, respectively; in total 37% of the total burden.

GPs are often the first contact point for mental health concerns and in 2008-09, over 13.2 million GP-patient encounters involved management of a mental health issue which was an increase of 5.7% from the previous year (Bettering the Evaluation and Care of Health Survey of GPs). Furthermore, in 2008-09, there were about 4.6 million Medicare claims for subsidised psychiatrist, psychologist, and other mental health-related allied health services compared with 3.9 million in 2007-08; an increase of 17.4%. This growth reflects the uptake of Better Access to Psychiatrists, Psychologist and GPs thorough the Medicare Benefits Schedule initiative introduced in November 2006. 

To meet the growing demands for access to allied health professionals, the Department of Health Ageing introduced the ATAPS (Access to Allied Psychologists Services) program which is funded thorough the networks or divisions of general practices throughout Australia. This program also supports access to other allied health professionals such as the Aboriginal health workers, mental health nurses, occupational therapists and social health workers with mental health training in addition to clinical psychologists and psychologists.

CSGPN has been administering the ATAPS program since 2005. Funded by the Commonwealth Department of Health and Ageing, the ATAPS program enables GPs to refer patients with mental health disorders to an allied health professionals, at no cost to that patient.

Funding for ATAPS program
Currently, there are two streams of funding for the ATAPS program: Tier 1 and Tier 2.

Tier 1 is for people with Anxiety, Depression and Stress. It is for individuals in areas with low access to Medicare based services or where Medicare based services are not affordable. It is also for ‘hard-to-reach’ groups such as Indigenous Australians and people from CALD background.

Tier 2 funding is additional funding intended to offer extra flexibilities and includes the following groups:

• women with perinatal depression
• children of women with perinatal depression
• individuals who are or are at risk of homelessness
• individuals who have attempted suicide or at high risk of suicide.

The funding CSGPN received is for one whole year i.e. from 1 July 2010-30 June 2011.

Funding -  Current Status
On 13 January 2011, CSGPN informed all the GPs by fax that the Tier 1 funding has all been fully committed to the all the clients who were referred to an allied health professional by the GP. This means that as of 13 January 2011, GPs would not be able to refer any new patients under this Tier 1 funding. 

However, CSGPN GPs can still refer Tier 2 patients .ie Perinatal [Perinatal period is deemed to be from conception to one year post natal] and Self Harm patients who are homeless or at risk of homelessness who require psychological services can also still be referred.

The Tier 2 stream is still going strong, and has sufficient funding to keep going till 30 June 2011.

Patients can still also be referred to allied health professionals using other referral pathways such as the Better Access to Psychiatrists, Psychologists and GPs via the MBS. CSGPN GPs who would like a list of local psychologists who are prepared to bulk bill patients should contact Mano or Karen at CSGPN.

CSGPN did make a formal approach to the Commonwealth Department of Health and Ageing, requesting more funding for the Tier 1 funding. CSGPN was informed that, owing to the devastating floods in Queensland and Victoria, Commonwealth Department of Health and Ageing have prioritised all funding to those flood-affected areas. Until further funding is available, Tier 1 funding for treating patients with Generalised Anxiety, Depression and Stress has to be temporarily suspended or ‘put on hold”.

Should you wish to discuss this matter further, please call me on 87524907 or email marumanayagam@csgpn.com.au