To look at patterns of care following a GP Mental Health Treatment Plan, patterns of care over the entire period of available data (i.e., the December 2006 quarter to the March 2009 quarter) were examined. This decision was made because treatment 'episodes' can continue across calendar years. Applying annual cut–offs to the data would potentially censor (i.e. truncate) an episode and thus underestimate the volume of services received.

The effect of censoring is illustrated in figure 6.1. The figure shows 3 simple examples of Better Access care patterns for Persons A, B and C. Person A has received a GP Mental Health Treatment Plan, followed by 6 sessions of Focussed Psychological Strategies, followed by a GP Mental Health Treatment Review. All services were received in the 2007 calendar year. If the period of interest for analysis was restricted to calendar year 2007, for example, this would capture all Better Access care received by this person, and would provide an accurate count of the number of allied health services services they received following the Treatment Plan. Person B has received has received a GP Mental Health Treatment Plan in 2007, followed by 6 sessions of Focussed Psychological Strategies in 2008. If the period of interest for analysis was restricted to calendar year 2007, none of the allied health services they received would be counted. Person C has received services across three calendar years. If the period of interest for analysis was restricted to calendar year 2007, only two of the allied health services they received following their first Treatment Plan would be counted, and the Treatment Review would not be counted. It is acknowledged however, that even by including all available data, there will still be some censoring effects. That is, the number of services received may still be underestimated for people with ongoing episodes that are not complete by the end of the period covered by the data.

The data presented describe the number of persons receiving Better Access services according to whether or not they received a GP Mental Health Treatment Plan with or without other services, over the period from the October 2006 quarter to the March 2009 quarter.

6.2.1 To what extent are GP Mental Health Treatment Plans followed by a GP Mental Health Treatment Review?

6.2.2 What level of allied health services are being received by persons who have a GP Mental Health Treatment Plan followed by a Review?

6.2.3 What level of allied health services are being received by persons who have a 2710 not followed by a 2712?

6.2.4 Does the number of allied services received vary according to number of GP Mental Health Plans received?

6.2.5 What are the socio-demographic characteristics of people not receiving allied health services following a GP Mental Health Treatment Plan?
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Figure 6.1 Simple examples of Better Access care patterns.

Text equivalent below for Figure 6.1 Simple examples of Better Access care patterns.

Notes:
Vertical lines represent calendar year break.
A = GP Mental Health Treatment Plan.
B = GP Mental Health Treatment Review.
x = Focussed Psychological Strategies.

Text version of Figure 6.1

Simple examples of Better Access care patterns by calendar year:
  • Person A:
    • 2007 - GP Mental Health Treatment Plan, 6 Focussed Psychological Strategies, GP Mental Health Treatment Review
  • Person B:
    • 2007 - GP Mental Health Treatment Plan
    • 2008 - 6 Focussed Psychological Strategies
  • Person C:
    • 2007 - GP Mental Health Treatment Plan, 2 Focussed Psychological Strategies
    • 2008 - 5 Focussed Psychological Strategies, GP Mental Health Treatment Review, GP Mental Health Treatment Plan
    • 2009 - 2 Focussed Psychological Strategies

6.2.1 To what extent are GP Mental Health Treatment Plans followed by a GP Mental Health Treatment Review?

Table 6.1 provides a summary of the total number of persons receiving any Better Access GP Mental Health Treatment Plan or Review service (MBS items 2710 or 2712) and the number of these services received.

The vast majority (just under 91%) of people who received a GP Mental Health Treatment Plan received only one of these services. A further 9% received two. People who received a GP Mental Health Treatment Review most often received either one (78%) or two (17%) of these services.

The data suggest that around 21% of consumers who received a GP Mental Health Treatment Plan also received a GP Mental Health Treatment Review, a ratio of approximately 5:1. In terms of services provided, the ratio of GP Mental Health Treatment Plans to Reviews was approximately 3.5:1. In some cases, a Review may not have occurred because the first Plan was conducted shortly before the end of the counting period, and there was insufficient time for a Review to have occurred. Even allowing for this, the data indicate that many Plans may not be reviewed using the Review itemTop of page.

Table 6.1 Total number of persons receiving Better Access services under MBS items 2710 or 2712, October 2006 quarter to March 2009 quarter, and number of 2710 and 2712 services received.

MBS itemN Services (Range)Persons
N
Persons
%
Services
N
Services
%
Services per Person (Mean)
27101
1,037, 673
90.7
1,037,673
82.8
1.0
27102
1028,822
9.0
205,644
16.4
2.0
27103
3,211
0.3
9,633
0.8
3.0
27104
23
0.0
92
0.0
4.0
27105+
2
0.0
10
0.0
5.0
2710Total
1,143,731
1,253,053
1.1
27121
126,291
77.6
216,291
59.9
1.0
27122
47,072
16.9
94,144
26.1
2.0
27123
11,058
4.0
33,174
9.2
3.0
27124
3,142
1.1
12,568
3.5
4.0
27125+
985
0.4
5,185
1.4
5.3
2712Total
278,548
361,362
1.3
2710 or 27121
815,062
71.2
815,062
50.5
1.0
2710 or 27122
233,394
20.4
266,788
28.9
2.0
2710 or 27123
64,624
5.6
193,872
12.0
3.0
2710 or 27124
20,481
1.8
81,924
5.1
4.0
2710 or 27125+
10,412
0.9
56,768
3.5
5.5
2710 or 2712Total
1,143,973
1,614,414
1.4

Data have regard to all claims processed up to and including 30 April 2009.

6.2.2 What level of allied health services are being received by persons who have a GP Mental Health Treatment Plan followed by a Review?

Table 6.2 summarises the number of Better Access allied health services received by persons who received both a GP Mental Health Treatment Plan and a GP Mental Health Treatment Review. Data are presented separately for people who received only one Plan/Review "pair" of these services and people who received a greater number of these items.

Table 6.2 shows that, of persons who received one Plan/Review pair, one quarter did not receive any Better Access allied health services. A further 28% received between 1 and 6 services, 35% received between 7 and 12 services and 12% received more than 13 services. The distribution is similar among those who received at least one Plan and/or at least one Review.

In interpreting these data, it is important to acknowledge that some consumers who did not receive Better Access allied health services may have received psychological services from other sources, for example: from allied health professionals under the ATAPS program (which is not recorded in the MBS); from their GP, which may be recorded using the Better Access GP Mental Health Consultation item (2713) or under another MBS item; or via privately funded services.Top of page

Table 6.2 Number of Better Access allied health services received (within ranges) by persons who had Better Access services under MBS items 2710 and 2712, December 2006 quarter to March 2009 quarter.

PersonsPercentage of persons receiving number of Allied health services within range:
0
Percentage of persons receiving number of Allied health services within range:
1-6
Percentage of persons receiving number of Allied health services within range:
7-12
Percentage of persons receiving number of Allied health services within range:
13-18
Percentage of persons receiving number of Allied health services within range:
19+
Persons who received one 2710/2712 pair
183,550
25.3%
27.5%
35.2%
8.9%
3.1%
Persons who received more than one 2710/2712 pair
92,517
22.66%
17.4%
19.2%
20.5%
20.3%

Data have regard to all claims processed up to and including 30 April 2009.
Data includes only those consumers who received Better Access services under MBS items 2710 and 2712.

6.2.3 What level of allied health services are being received by persons who have a 2710 not followed by a 2712?

Table 6.3 summarises the number of Better Access allied health services received by persons who received a GP Mental Health Treatment Plan (2710) but did not receive a GP Mental Health Treatment Review (2712). Data are presented separately for people who received only one GP Mental Health Treatment Plan and people who received two. The number of people who received more than two 2710 services (without a 2712) is too small to provide reliable patterns.

Table 6.3 shows that, of persons who received one GP Mental Health Treatment Plan but no Review, almost half (48%) had received no Better Access allied health services. A further 44% had received 1 to 6 services, 6% received 7 to 12 services, and 12% received 13 or more services. As noted in the previous section, the large percentage of people who received no allied health services may be, in part, be explained by receiving psychological services under other programs or MBS items. It may also capture people whose Plan occurred late in the observation period and for whom insufficient time has accrued for a service to have been received.

Table 6.3 Number of Better Access allied health services received (within ranges) by persons who had Better Access services under MBS items 2710 but did not have a follow–up 2712, December 2006 quarter to March 2009 quarter.

PersonsPercentage of persons receiving number of Allied health services within range: 0Percentage of persons receiving number of Allied health services within range: 1-6 Percentage of persons receiving number of Allied health services within range: 7-12 Percentage of persons receiving number of Allied health services within range: 13-18 Percentage of persons receiving number of Allied health services within range: 19+
Persons who received one 2710 services but no 2712 services
814,841
47.8%
44.2%
6.4%
1.2%
0.4%
Persons who received two 2710 services but no 2712 services
49,832
28.4%
41.8%
17.8%
7.3%
4.6%

Data have regard to all claims processed up to and including 30 April 2009.

6.2.4 Does the number of allied services received vary according to number of GP Mental Health Plans received?

This question considers whether the number of Better Access allied health services varies as number of GP Mental Health Treatment Plans increases. People who had at least one GP Mental Health Treatment Plan (2710) and at least one GP Mental Health Treatment Review (2712) were considered first. For this analysis it was assumed that people who received 2 services most likely received one "episode" of care (where an episode is defined as a Plan followed by a Review, even if the Review was for the purpose of initiating a further episode). It was also assumed that people who received more than 3 services are most likely to have had two episodes (a 2710 followed by a 2712, followed by a further 2712 or a new 2710). People who received 4 services may have received two discrete episodes (2710 followed by 2712) or 3 contiguous episodes (2170 followed by a 2712, then another 2712), hence data are provided in a range to cover both scenarios, and so on.

Table 6.4 indicates that the average number of Better Access allied health services does not change, or may decrease somewhat, as number of episodes of Better Access care increases.

Table 6.5 indicates some variation in average number of Better Access allied health services according to number GP Mental Health Treatment Plans received among people who received GP Mental Health Treatment Plan services but no GP Mental Health Treatment Review services. The average number of allied health services increases between 1 and 3 GP Mental Health Treatment Plan services. The numbers of people receiving more than 3 Plans is very small hence these data have not been reported.
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Table 6.4 Number of Better Access allied health services received and Number of 2710/2712 services received by persons who had Better Access services under MBS items 2710 and 2712, December 2006 quarter to March 2009 quarter.

Number of 2710/2712 services PersonsNumber of Allied health services received TotalNumber of Allied health services received Mean per episode
2: One episode
183,550
1,190,540
6.5
3: 2 episodes
63,871
638,860
5.0
4: 2-3 episodes
20,475
276,510
4.5 - 6.8
5+: 3-4 episodes
10,410
152,178
3.7 - 4.9

Data have regard to all claims processed up to and including 30 April 2009.

Table 6.5 Number of Better Access allied health services received and Number of 2710 services received by persons who had Better Access services under MBS items 2710 but did not have a follow–up 2712, December 2006 quarter to March 2009 quarter.

Number of 2710 servicesPersonsNumber of Allied health services received TotalNumber of Allied health services received Mean per episode
1
814,841
1,790,735
2.2
2
49,832
261,288
2.6
3
745
8,546
3.8

Data have regard to all claims processed up to and including 30 April 2009.

6.2.5 What are the socio-demographic characteristics of people not receiving allied health services following a GP Mental Health Treatment Plan?

A subgroup of particular interest, as indicated by the previous analyses in this chapter, are those Better Access consumers who do not appear to be receiving allied health services following a GP Mental Health Treatment Plan.

As indicated by the previous analyses, there are a number of difficulties in profiling patterns of Better Access treatment to examine such issues. In particular, it is difficult to delineate 'episodes' of Better Access care in order to explore patterns of service use. The following analysis profiles patterns of care following the first GP Mental Health Treatment Plan (2710) items received by each consumer, up until their next Plan or GP Mental Health Treatment Review (2712). This involved identifying the first Plan item for each consumer referral occurring prior to 30 June 2008, and determining whether it was followed by one or more Psychological Therapy Services or Focussed Psychological Strategies services at any time up until the next Plan or review items, or the end of the March quarter 2009 (the latest date of data available). The cut–off date of 30 June 2008 for the inclusion of Plans was chosen because protocol for the Review of a GP Mental Health Treatment Plan item (2712) is that:

An initial review should take place a minimum of 4 weeks and a maximum of 6 months after the completion of the Mental Health Treatment Plan (2710). If required, an additional review 3 months after the first review is allowed in a 12 month period.
This method allows for a minimum of 9 months of observation for each person following their first Plan, which should be sufficient time in which to accrue at least one allied health service. Table 6.6 shows the percentages of Better Access consumers who received, and who did not receive, any Better Access allied health services following their first GP Mental Health Plan (item 2710), according to age group, gender, region and socio–economic disadvantage.
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The key messages from this table are:
  • Overall, 58.2% of Better Access consumers who received at received at least one Better Access allied health service following their first Plan. Conversely, 41.8% did not.

  • Older people aged 65 years or more showed the highest percentage of non–receipt of Better Access allied health services following a Plan (53.3%), whereas people aged 15 years or less had the lowest percentage (29.8%). The percentage for all other age groups was similar to the average for all Better Access consumers (41.8%).

  • Non–receipt of Better Access allied health services following a Plan was somewhat higher for males (44.0%) than females (40.6%).

  • Non–receipt of Better Access allied health services following a Plan increased considerably as level of geographical remoteness increased. Rates of non–receipt of allied health services following a first Plan were similar to the average for all Better Access consumers for people in capital cities and other metropolitan regions, but were 10% lower for people in rural centres, 19.6% lower for people in other rural areas, and 47.8% lower for people in remote areas.

  • Non–receipt of Better Access allied health services following a Plan increased as level of socio–economic disadvantage increased. Rates of non–receipt of allied health services following a first Plan were 14.6% higher for people in capital cities, but were 14.4% lower for people in other rural areas and 15.1% lower for people in remote areas.

As noted already in section 6.2.2, it is important to acknowledge that some consumers who did not receive Better Access allied health services may have received psychological services from other sources.

Table 6.6 Consumers receiving Better Access allied health services following their first GP Mental Health Plan (item 2710), according to age group, gender, region and socio–economic disadvantage, December 2006 quarter to March 2009 quarter.

Consumers who received a GP Mental Health Treatment Plan
N
Consumers who received at least one Better Access allied health service
N
Consumers who received at least one Better Access allied health service
%
Consumers who did not receive any Better Access allied health service
N
Consumers who did not receive any Better Access allied health service
%
Age group - 0-14 years
56,373
40,070
71.1
16,303
28.9
Age group - 15-24 years
139,580
76,226
54.6
63,354
45.4
Age group - 25-34 years
194,150
111,267
57.3
82,883
42.7
Age group - 35-44 years
207,452
123,451
59.5
84,001
40.5
Age group - 45-54 years
159,658
94,620
59.3
65,038
40.7
Age group - 55-64 years
93,705
55,111
58.8
38,594
41.2
Age group - 65+ years
49,198
22,980
46.7
26,218
53.3
Gender - Male
320,645
179,560
56.0
141,085
44.0
Gender - Female
579,471
344,165
59.4
235,306
40.6
Regiona - Capital cities
593,605
360,185
60.7
233,420
39.3
Regiona - Other metropolitan centres
82,629
47,562
57.6
35,067
42.4
Regiona - Rural centres
122,402
66,146
54.0
56,256
46.0
Regiona - Other rural areas
93,452
46,764
50.0
64,688
50.0
Regiona - Remote areas
8,028
3,068
38.2
4,960
61.8
SE disadvantageb - Quintile 5 (Least)
247,452
159,183
64.3
88,269
35.7
SE disadvantageb - Quintile 4
195,902
119,191
60.8
76,711
39.2
SE disadvantageb - Quintile 3
184,656
103,174
55.9
81,482
44.1
SE disadvantageb - Quintile 2
152,495
79,579
52.2
72,916
47.8
SE disadvantageb - Quintile 1 (Most)
110,998
57,626
51.9
53,372
48.1
Total
900,116
523,725
58.2
376,391
41.8

Data have regard to all claims processed up to and including 30 April 2009.
a Region based on RRMA classification.
b Socio–economic disadvantage based on IRSD classification. Note that the data for socio–economic disadvantage exclude people for whom this data are missing.