General Practitioners, Pediatricians and Psychiatrists

Who to refer?

• Patients with emotional, behavioural, relationship, health, situational or cognitive
  difficulties who would benefit from psychological assessment, therapy or counselling.
• Patient’s requiring Specialist Psychological Therapy under Medicare. Please note that
  we are happy to accept patients for group therapy who are currently having psychotherapy or focused psychological interventions with another provider.
• Patients in the community who have chronic suicidal ideation or parasuicidal
  behaviours but are not acutely suicidal (please see Risk Assessment Link) (under Item 2710).
• Private in-patients of aged care facilities (Item No. 731)
• Private patients being discharged from a public hospital e.g.  Mental Health Unit (after
  Item No 729 – Contribution to a Multidisciplinary Care Plan).
• Private patients under a referred a Psychiatrist Assessment and Management Plan
  (Item 291)
• Patients whose symptoms are no longer severe enough to warrant the involvement of
  the mental health service.
• Patients with a mental illness who are not adhering or accepting of medication to manage symptoms.

How to refer?

• GPs – After the completion of a GP Mental Health Care Plan (Item No. 2710) or a
  referred psychiatrist assessment and management plan (Item No. 291) and these
  have been claimed on Medicare, Insight is able to provide psychological therapies.
  We are happy to accept the plan as a referral, please ensure your provider number
  is on the plan.

• Pediatricians – Brief letter via fax or email stating patient’s difficulties or diagnosis
  (if warranted) and any specific assessment or therapy that you wished to be undertaken.
  Please direct to Dr Margaret Judd, referrals concerning assessment and management
  plan for Autism.  Please provide copies of any relevant reports or letters with referral.

• Psychiatrists - Brief letter via fax or email stating patient’s difficulties and/or diagnosis
  (if warranted) and any specific assessment or therapy that you wished to have undertaken (e.g. CBT, DBT, ACT, Interpersonal Therapy and soon EMDR). Please provide copies of any relevant reports or letters with referral.

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Preparation of GP Mental Health Care Plan (www. health.gov.au )
(Item No. 2710)

The assessment and plan can be conducted simultaneous or completed on separate visits.
The formal documentation of the plan may be done with the assistance of a practice nurse with
appropriate training in mental health.

Assessment – Involves 6 steps

1. Consent
2. Relevant History (biological, psychological, social) including present complaint
3. Mental Status Examination
4. Assessment of associated risk and any co-morbidity
5. Diagnosis and/or formulation
6. Outcome tool (preferred by Insight – K(10) or  HoNOSCA, HoNOS, HoNOS 65+)

Plan - Involves 6 steps

1. Discuss diagnosis and provide psycho-education
2. Identify and discuss treatment and referral options
3. Set goals for treatment and specific actions the patient will take
4. Plan for crisis intervention (and or relapse prevention if appropriate)
5. Make arrangements for required referrals, treatment, appropriate
   support services, review and follow-up.
6. Document assessment results and above in GP Mental Health Care
   Plan and offer copy to patient and where appropriate career.

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Mental Health Care Plan Proformas

• Located on DoHA website – www.health.gov.au/internet/wcms/publishing.nsf /Content/health-pcd-gp-mental-health-care-medicare.
• Electronic Templates for Medical Director or Practix - www.gppartners.com.au/page/practice_support/programs_support/brisbane
  _mind/brisbane_mind_forms/
• Medical Director - www.nevdgp.org.au

Links to Outcome Measures

• Child & Youth Strengths and Difficulties Questionnaire - http://www.sdqinfo.com/b5.html
• DASS - http://www2.psy.unsw.edu.au/groups/dass//
• Edinburgh Postnatal Depression Scale - http://health.utah.gov/rhp/pdf/EPDS.pdf
• Geriatric Depression Scale - http://www.merck.com/mkgr/mmg/tables/33t4.jsp
• Hamilton Rating Scale for Depression - http://healthnet.umassmed.edu/mhealth/HAMD.pdf
• HoNOS - www.gpcare.org/outcome%20measures/outcomemeasures.html
• HoNOSCA -  http://www.liv.ac.uk/honosca/Home.htm
• K-10 - www.gppartners.com.au/page/practice_support/programs_
  support/brisbane_mind/brisbane_mind_forms/
• SF12 - www.gpcare.org/outcome%20measures/outcomemeasures.html
• National Mental Health Outcomes and Casemix collection (contains
  hardcopies HoNOS 65+, LSP-16, Rug_ADL, MHI-38, BASIC-32, FIHS, CGAS) -  http://www.mhnocc.org/resources/national_outcomes_and_casemix_
  collection/NOCC_Clinical_Self_Report_Measures_Overview_V1_5.pdf

Risk Assessment for Suicidal Patients

If your patient has 4 or more of the following, risk factors, depending on the severity of their presentation please call an ambulance or refer to them Fraser Coast Integrated Mental Health Service as they may need services as an outpatient from the Acute Care Team or an admission to the Mental Health Unit during this crisis.

• Expressing suicidal thoughts
• Clear intent to act on suicidal thoughts – definite plan with no protective factors
• Availability to means that are lethal and/or a plan to arrange circumstance where they cannot be saved.
• Past history of life threatening attempts
• Substance use – current or recent history
• Recent Major Stressor (e.g. marital breakdown or financial stressor)
• Major Mental Illness (Untreated or insufficiently managed, break through symptoms)

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