First mental illness to be assigned MBS diagnostic category

In an Australian first, eating disorders (ED) represent the first mental health disorder to be assigned specific item numbers under the revised Medicare Benefits Schedule (MBS) scheme, commencing November 1, 2019. This development has sparked an urgent call by ED experts to the Australian health workforce to upskill in the management of these complex illnesses.

Announcement of the pending MBS revisions, coinciding with World Mental Health Day today (Thursday, October 10, 2019) and an article just published in MJA Insight , marks an important milestone for the million Australians living with an ED who will gain access to 40 rebated psychological therapy sessions and 20 dietetic sessions (an increase of 30 and 15 sessions, respectively).

According to Director of InsideOut Institute for Eating Disorders (IOI), Dr Sarah Maguire, EDs are curable for many if a person receives the correct treatment, at the right time, with access to an appropriately trained multidisciplinary team, including, at minimum, a medical practitioner, a psychologist, and in most cases, a dietitian.

“Both national and international guidelines recommend a skilled multidisciplinary treatment approach for EDs, and access to between 40 – 50 sessions, in order to achieve satisfactory remission.

“Prior to the upcoming revision of the MBS, patients living with EDs, and all other mental health disorders, have had access to just 10 rebated psychological sessions through Medicare,” said Dr Maguire.

“While EDs have one of the highest mortality rates of any mental illness, concerningly, more than 70 per cent of people living with EDs do not receive treatment, and of those who do, only 20 per cent receive evidence-based treatment.”

Under the new scheme, diagnosis by a general practitioner and mental health practitioner will be required, in recognition of the significant physical burden imposed by these psychiatric illnesses, which necessitates integrated treatment.

“The Eating Disorder Working Group Report, which underpins the updated MBS, outlines the minimum training standards required by providers to achieve timely diagnosis and treatment. Under the new scheme, treatment options available will be limited to the defined list of evidence-based eating disorder specific treatments,” Dr Maguire said.

“As a major eating disorder workforce development provider, IOI delivers a range of online, evidence-based eLearning training packages. I therefore urge any healthcare professional working with people living with EDs, to consider upskilling, in order to best support their patients,” said IOI Senior Clinical Dietitian, Gabriella Barclay.

“Under the new scheme, there will be 64 specific MBS item numbers for the treatment of anorexia nervosa, bulimia nervosa, binge eating disorder and atypical presentations, creating an opportunity to analyse treatment uptake or response.

“The MBS will allow Australians living with severe EDs, and their carers’, to access comprehensive treatment plans, saving patients and their families thousands of dollars each year.” Ms Barclay said.

Three-time Olympic hurdler, IOI ambassador and recently qualified medical doctor, Jana Pittman, Sydney, has similarly welcomed the MBS news, but warned Australians need support to find suitable trained healthcare providers in their local area.

“As someone who has lived with an eating disorder, and is now trained as a healthcare professional, I am familiar with the various barriers faced by those who require professional help, but are unsure where to turn.

“A major barrier is finding someone who is skilled, who you can trust, who will empathise with you, and understand your situation. Importantly, IOI’s online Treatment Services Database allows Australians living with an ED to identify a local healthcare professional simply, at the touch of a button on their website,” said Ms Pittman.

Register for an IOI ED training module and access information on the MBS changes.