Navigating Medicare mental health treatment plans and referrals can be complex for both clients and practitioners.
For psychologists, clinical social workers, and other mental health professionals, understanding the key aspects of these processes is crucial for ensuring smooth access to care. The Better Access is an Australian government initiative that gives Medicare benefits to eligible people, so they can access the mental health services they need wherever they live in Australia. Better Access aims to enhance the treatment and management of mental illnesses while encouraging more Australians to seek support for their mental health challenges, regardless of where they live. This guide outlines the difference between a mental health treatment plan and a referral, along with important considerations for practitioners and patients/clients.
What is a GP Mental Health Treatment Plan?
A GP Mental Health Treatment Plan (MHTP) is structured document created by a general practitioner (GP) to assess and support a patient’s mental health needs. It provides:
- A comprehensive overview of the patient’s mental health history and current concerns.
- Goals and strategies for addressing mental health issues, such as therapy or lifestyle adjustments.
- Access to Medicare benefits for up to 10 (6+4) subsidized therapy sessions per calendar year with eligible mental health professionals (as per regular updates).
The MHTP acts as a roadmap for treatment and ensures continuity of care between the GP and mental health practitioners.
What is a Referral?
A referral is a formal document or letter provided by the GP to direct the patient to a specific mental health professional, such as a psychologist, psychiatrist, mental health accredited social worker or occupational therapist. While the MHTP establishes the need for care, the referral identifies the practitioner to deliver that care.
Key points about referrals include:
- Referrals usually accompanies a MHTP for patients to access Medicare rebates for therapy sessions.
- Referrals may specify a named provider or allow the patient to choose from a list of qualified practitioners.
- Referrals can cover a set number of sessions (e.g. 6), after which a review with the GP is required to approve additional 4 sessions.
Allied health professionals can claim Medicare benefits for some services.
Practitioners/Allied health professional eligibility: Under Better Access initiative, the following mental health professionals can provide therapeutical services:
- Clinical psychologists
- Registered psychologists
- Mental health accredited social workers, and
- Mental health accredited occupational therapists
Challenges for Practitioners and Clients
Mental health professionals often encounter challenges when managing MHTPs and referrals. Here are some key considerations:
- Incomplete or unclear referrals: A referral must clearly state the patient’s details and the intended provider. Practitioners should confirm these details before beginning treatment to avoid administrative issues.
- Session reviews and Medicare limits: Patients/clients may not understand that they need a GP review after their initial six sessions. Practitioners can help by reminding clients of this requirement to avoid service disruptions.
- Collaboration with GPs: Building strong communication with referring GPs ensures a shared understanding of the patient’s needs and supports better treatment outcomes.
Benefits of Clear Processes
Streamlining MHTPs and referrals is not just an administrative exercise; it directly benefits clients by reducing barriers to accessing mental health care. Educating patients/clients about the process empowers them to advocate for their needs while maintaining compliance with Medicare requirements.
By understanding these systems and fostering collaboration, mental health professionals can play a key role in providing seamless, effective care.
Disclaimer: this is for informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. 
Author: Nenad Bakaj, MHumServ (RehabCouns), BSocWk, DipAppSci (Comm&HumServ), AMHSW, MAAC, MAASW, JP (Qld)
Nenad Bakaj is a Brisbane based Clinical Counsellor, Accredited Mental Health Social Worker, Life Coach and Bigger Bite Out Of Life Trainer with a keen interest in positive psychology, mental health and wellbeing, and is continually developing his professional skills and knowledge. Nenad enjoys working with adolescents and young adults, as well as older clients, and feels it is a privilege to be able to support them.
References
1. Australian Government Department of Health and Aged Care. (2023). Better Access initiative: Medicare benefits for mental health services. Retrieved from www.health.gov.au.
2. Services Australia. (2023). Medicare mental health treatment plans. Retrieved from www.servicesaustralia.gov.au.