Small regulatory change could make a huge difference for Australians accessing mental health care


The Australian Private Hospitals Association (APHA) is calling for a small change which could make a big difference in the lives of people dealing with mental health issues.

Making private hospital mental health care available to all could address a key reform suggested by the Productivity Commission’s draft report on mental health care in Australia.

The draft report makes 25 recommendations, including greater early intervention for children and young people, and for all levels of government to work together to close the gap.

APHA acting CEO, Lucy Cheetham, said the Commission had identified a key issue for accessing private hospital mental health care. 

“The Commission is exactly right to point to the ‘missing middle’ in mental health services,” she said.

“People with severe mental health conditions need a range of well-coordinated supports and help prevent them from deteriorating to the point where they need acute hospital care.

“They also need co-ordinated, multidisciplinary care to support them after discharge from hospital.

“Thankfully, this could reasonably easily be addressed, at least in part, by making a small regulatory change and extending the default minimum benefit private health insurers must pay on overnight care, to day and community out-reach programs as well. 

“While the default benefit for overnight care is still very low, it is mandatory for all private health insurance policies and does mean that in a time of crisis, patients can go to their hospital of choice. 

“However, it does not apply across all mental health services and is a barrier to innovative programs being established in the private sector.”

Ms Cheetham said a program like Toowong Private Hospital’s award winning Mobile Recovery Support Service was only available to Bupa members, but if a default benefit existed, the hospital could offer it to all patients who need it.

“This is real patient-centred care, where the kind of services you can access are not dictated by the private health insurance fund you belong to,” she said.

“If your insurer has not contracted with a private hospital to offer day services, you cannot access it. No contract means no cover, even if you have top level gold policy.’’

Toowong Private Hospital CEO, Christine Gee, told PH News that the Mobile Recovery Support Service offered individually-tailored, one-to-one, time-limited support that enabled the patient to enhance their quality of life.

“This partnership with Bupa has enabled us to offer a more comprehensive approach to the delivery of mental health care and services,” she said.

“The service provides a multidisciplinary team to assist our patients in the community.

“This is contemporary care for the treatment of mental health conditions that enables us to deliver the right care in the right place at the right time.

“It’s a shame we can’t provide this service to all of our patients, hopefully other health insurers will come on board at some point.”

According to the Productivity Commission’s draft report, mental illness and suicide is costing Australia $500 million a day.

Up to 3.9 million Australians have a mental illness and one million of those are not accessing services.

Up to 75 percent of people who have a mental illness will develop symptoms before they turn 25 and according to Productivity Commissioner Stephen King, more needed to be done, particularly for young people.

The report recommended changes to health services, schools, workplaces, housing and the justice system. Better follow up care – particularly after a suicide attempt – is vital.

Mental Health Australia acting CEO, Melanie Cantwell, said the draft report had the potential to be a defining moment for systemic mental health and suicide prevention reform.

“The commission has clearly understood the scale and breadth of the challenge to improve the mental health system and said substantial reform of Australia’s mental health system is needed,” she said.

“For many months we’ve said the Productivity Commission inquiry is a once-in-a-generation opportunity for mental health, and we can all make the most of this opportunity, and the many opportunities recommended throughout the draft report.

“At the core of the report, is the push for a new national agreement for mental health, which has also been at the heart of our 'Charter 2020: Time to Fix Mental Health', now co-signed by more than 110 mental health and suicide prevention organisations nationally.”

Ms Cheetham called on the Federal Government to amend regulations to mandate a minimum benefit for day programs, out-reach and community programs provided by private hospitals.

“There are 37 different health insurers in Australia, and it is heartbreaking to have to explain to patients that the service they need is not covered because they are with the wrong insurer,” she said.

She added the APHA welcomed calls by the Productivity Commission to increase the number of training places for psychiatrists including positions in the private sector.


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