Mental health by telehealth gets boost but more changes needed

Medical News: The Royal Australian and New Zealand College of Psychiatrists (RANZCP) welcomes the most recent set of changes to expand Medicare-subsidised telehealth and telephone services, including for psychiatry services, to even more Australians.

‘We have been advocating directly to the government for an expansion of telehealth services for a wider range of consultations, and these latest adjustments will further strengthen telehealth as a key measure in the fight against this pandemic,’ said RANZCP President, Associate Professor John Allan.

‘This is good news for new patients who will for the first time be able to meet with a psychiatrist via telehealth or telephone rather than having to see them face to face during these difficult times.

‘It will reduce the risk of exposure and the spread of COVID-19 by allowing more people to access essential health services in their home, especially those in self-isolation and quarantine who may have or develop a need to seek help for their mental health.

‘The expanded Medicare items also mean that psychiatrists can work with general practitioners via telehealth to develop treatment plans for managing patients with mental health conditions. Integration of services is now more vital than ever.’

The RANZCP notes that there remain a range of mental health services such as group therapy and inpatient services, which are not covered by these changes.

‘In situations where group consultations have had to cease, psychiatrists must be able to continue this type of therapy by telehealth,’ said Associate Professor John Allan.

‘Many of these group sessions would otherwise run once or twice a week and include people with severe and longstanding depression, eating disorders, anxiety, childhood abuse and a whole range of severe mental illnesses – without the support of group therapy there are all sorts of risks such as relapse of illness, substance misuse and worst of all, suicide.

‘Family group therapy plays an especially valuable role in addressing mental health issues and would in many cases be able to continue if made available by telehealth. It is important to counter the negative effects of isolation for vulnerable young people and families.

‘The option to provide telehealth-based care for people with health conditions whilst they are admitted to hospital (inpatient care) is another important measure to ensure continuity of care and would help keep mental health professionals working and contributing to the broader public health effort.

Associate Professor Allan said this would allow those psychiatrists who are forced to self-isolate but who remain otherwise healthy, for example, to continue their much needed therapy with patients in hospital as well.

In other changes, there are new legislative requirements for bulk billing which carry a range of service implications that will need ongoing monitoring and review.

The RANZCP will continue to work with the respective levels of governments on these and other issues to ensure that whole of population telehealth is available for psychiatry and mental health.