Australia’s ‘Better Access’ scheme: Has it had an impact on population mental health?

2018 ◽  
Vol 52 (11) ◽  
pp. 1057-1062 ◽  
Author(s):  
Anthony F Jorm

Background: Australia introduced the Better Access scheme in late 2006, which resulted in a large increase in the provision of mental health services by general practitioners (GPs), clinical psychologists, other psychologists and allied health professionals. It is unknown whether this increase in services has had an effect on the mental health of the population. Methods: The following data were examined: per capita use of mental health services provided by GPs, clinical psychologists, other psychologists, allied health professionals and psychiatrists from 2006 to 2015 according to the Australian Government Department of Human Services; prevalence of psychological distress in adults (as measured by the K10) from National Health Surveys in 2001, 2004–2005, 2007–2008, 2011–2012 and 2014–2015; and the annual suicide rate from 2001 to 2015 according to the Australian Bureau of Statistics. Results: The large increase in the use of mental health services after the introduction of the Better Access scheme had no detectable effect on the prevalence of very high psychological distress or the suicide rate. Conclusion: Better Access has not had a detectable effect on the mental health of the Australian population.

2020 ◽  
pp. 000486742097686
Author(s):  
Anthony F Jorm ◽  
Betty A Kitchener

Background: Mental disorders often have their first onset during youth, which justifies targeting treatment services at this age group. Australia has had a substantial increase in youth mental health services since the introduction of the Medicare Better Access scheme and headspace services in 2006–2007. This paper examines trends in the mental health of Australian youth before and after this time using available national and state datasets. Methods: The following data were examined for age groups available in the age range of 12–25 years: use of mental health services per 100,000 population provided under Medicare by GPs, psychiatrists, clinical psychologists, other psychologists and allied health professionals; per capita accessing of headspace services; and prevalence of high and very high psychological distress (using the K10) in youth age groups in the National Health Survey, the Victorian Population Health Survey and the New South Wales Population Health Survey between 2001 and 2018. Results: There has been a large increase in use of mental health services since the introduction of Better Access and headspace. No significant improvement in youth mental health was evident following the introduction of these schemes. Rather, there appeared to be a worsening of youth mental health from around 2015 onwards. Conclusion: Despite a large increase in the provision of mental health services to Australian youth, there has not been a detectable reduction in the prevalence of psychological distress. There may be other factors that have worsened youth mental health in recent years.


2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.


Author(s):  
Eric G. Mart

This chapter provides information designed to assist mental health professionals in effectively marketing their services to courts, attorneys, and the legal system in general. Suggestions are offered to help mental health professionals decide whether they will be comfortable working in an adversarial environment. Methods for developing the skillsets necessary for performing forensic consultations in a competent, ethical manner are provided. Information regarding how to effectively market mental health services to legal professionals are reviewed. Various areas of subspecialty practice are described.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S21-S22
Author(s):  
Andrew McAleavey ◽  
Mariel Emrich ◽  
Adina R Jick ◽  
Collette L McGuire ◽  
JoAnn Difede

Abstract Introduction Psychological distress, including posttraumatic stress disorder, acute stress disorder, and depressive disorders, are common after burn injury. These conditions are major determinants of long-term quality of life and productivity loss among burn patients, yet are generally under treated. Among the many reasons for limited treatment are lack of accessible quality care, limited clinical staff expertise in assessing these conditions, and patient avoidance of effective services. Methods During December 2018 to September, 2019, patients awaiting outpatient visits at an urban burn center were asked to complete brief standardized self-report questionnaires assessing symptoms of posttraumatic distress, anxiety, and depression. Using pre-defined criteria, we attempted to reach individuals with greater than moderate distress using contact information provided voluntarily and engage these patients in outpatient mental health services. Results 747 questionnaires were completed by 511 individuals in the assessment period, and of these 98 (19.2%) individuals had a likely PTSD diagnosis. Visual analog scale assessments for current anxiety, depression and stress all suggested high average distress in the overall group. Using pre-defined criteria to identify potential distress, we identified 195 people (38.2%) to whom we would proactively offer services. Only 159 provided contact information, and several more were not eligible for available clinical services so were not contacted. We called 128 individuals (81%). This led to direct communication with 48 patients (37.5% of those contacted), but only 22 individuals (17.2% of all those contacted) still endorsed distress at the time of the phone call (which was planned to occur within one week of the patients’ report) and 11 individuals were interested in seeking mental health services. Of these, 4 were referred to other services, 3 declined specific offers of service, 4 were scheduled for appointments and only 2 individuals attended appointments with the in-hospital psychological trauma group. Conclusions Psychological distress is highly prevalent in the burn outpatient clinic, with roughly one in five patients likely meeting criteria for PTSD. However, engaging patients in psychological and psychiatric treatment remains a major challenge for the effective care in this population. We discuss strategies tried here and systemic barriers to overcome in future research and care. Applicability of Research to Practice High prevalence of PTSD in outpatient burn clinics and difficulty engaging patients in separate outpatient mental health services suggest co-located and collaborative care models would be highly helpful in this population.


1997 ◽  
Vol 2 (6) ◽  
pp. 398-399
Author(s):  
Ian G Manion ◽  
Simon Davidson ◽  
Christina Norris ◽  
Sarah Brandon

Abstract Today's youth are at a disturbingly high risk for mental health and illness problems and are largely dissatisfied with the existing mental health services. Youth Net/Réseau Ado (YN/RA), supported by input from mental health professionals, is a bilingual mental health promotion program that seeks out the opinions and attitudes of youth regarding mental health and illness issues, while connecting them with appropriate resources and mental health services. This paper describes the Youth Net/Réseau Ado program and provides some guidelines for the identification of mental health and illness problems, including indicators of the risk of suicide.


2020 ◽  
Vol 50 (2) ◽  
pp. 616-633 ◽  
Author(s):  
Michael Bonnet ◽  
Nicola Moran

Abstract The number of people detained under the 1983 Mental Health Act has risen significantly in recent years and has recently been the subject of an independent review. Most existing research into the rise in detentions has tended to prioritise the perspectives of psychiatrists and failed to consider the views of Approved Mental Health Professionals (AMHPs), usually social workers, who ultimately determine whether detention is appropriate. This mixed-methods study focused on AMHPs’ views on the reasons behind the rise in detentions and potential solutions. It included a national online survey of AMHPs (n = 160) and semi-structured interviews with six AMHPs within a Community Mental Health Team in England. AMHPs reported that demand for mental health services vastly exceeded supply and, due to inadequate resources, more people were being detained in hospital. AMHPs argued that greater investment in preventative mental health services and ‘low intensity’ support would help to mitigate the impact of social risk factors on mental health; and greater investment in crisis services, including non-medical alternatives to hospital, was required. Such investment at either end of the spectrum was expected to be more effective than changes to the law and lead to better outcomes for mental health service users.


1994 ◽  
Vol 18 (9) ◽  
pp. 544-547 ◽  
Author(s):  
Richard Tillett

The Royal College of Psychiatrists (1991) has recommended that all local mental health services should include specialist psychotherapy departments. At present these are uncommon outside major teaching centres, although a considerable amount of simple psychotherapy is provided on an ad hoc basis by mental health professionals of various disciplines. This paper describes the structure, functioning and costs of a specialist department in a non-teaching district in the south west of England.


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