Abstract
BackgroundRegionally-specific approaches to primary mental health service provision through Primary Health Networks (PHNs) have been a feature of recent national mental health reforms. No previous studies have been conducted to investigate local patterns of primary mental health care (PMHC) services in Western Sydney. This study is designed to (i) understand the socio-demographic and economic profiles (ii) examine the inequalities of service access, and (iii) investigate the service utilisation patterns, among those referred to PMHC services in Western Sydney, Australia.MethodsThis study used routinely collected PMHC data (2005–2018), population-level general practice and Medicare rebates data (2013–2018) related to mental health conditions, for the population catchment of the Western Sydney PHN. Sex- and age-specific PMHC referrals were examined by socio-demographic, diagnostic, referral- and service-level factors, and age-specific referrals to PMHC services as a percentage of total mental health encounters were investigated.ResultsThere were 27,897 referrals received for 20,507 clients, of which, 79.19% referrals resulted in follow-up services with 138,154 sessions. Overall, 60.09% clients were female, and median age was 31 years with interquartile ranged 16–46 years. Anxiety and depression were the predominant mental health condition, and 9.88% referred for suicidal risk. Over two-thirds of referrals started treatments during the first month of the referral and 95.1% of the total sessions were delivered by face to face. The younger age group (0–24) had greater referral opportunities as a percentage of total visits to a general practitioner and Medicare rebates, however demonstrating poor attendance rates with reduced average sessions per referral compared with older adults.ConclusionChildren and young adults were more likely to be referred to PMHC services than older adults, but were less likely to attend services. Further research is needed to identify the strategies to address these differences in access to PMHC services to optimise the effectiveness of services.
Highlights
Mental and substance use disorders are the second leading cause of disease burden in Australia, accounting for 15% of total disease burden in terms of disability adjusted life years [1]
79% of referrals resulted in a subsequent attendance to a mental health service representing a 138,154 total sessions (Median number of session = 6, interquartile range 3 to 8), with just over 75% of follow-up appointments occurring within 1-month, and the majority of treatments (95%) were delivered by face to face, while clients did not attend for 1971 (1.41%) scheduled sessions (Table 1)
Our study findings indicated that people experiencing mental health conditions have access to the primary mental health care (PMHC) services with an increasing trend in each year
Summary
Mental and substance use disorders are the second leading cause of disease burden in Australia, accounting for 15% of total disease burden in terms of disability adjusted life years [1]. Differential access is evident among specific socio-demographic groups, for example children and adolescents, people from culturally and linguistically diverse backgrounds, and Aboriginal and Torres Strait Islander populations [5,6,7] In response to this significant population health burden, the federal government established the Better Outcomes in Mental Health Care Programme in 2001 to facilitate access to mental health services. As part of this program, General Practitioners (GPs) were provided incentives to work collaboratively with mental health professionals under the Access To Allied Psychological Services (ATAPS) and to refer patients with mental disorders to receive psychological therapies at no cost or at low cost [8]. This study is designed to (i) understand the socio-demographic and economic profiles (ii) examine the inequalities of service access, and (iii) investigate the service utilisation patterns, among those referred to PMHC services in Western Sydney, Australia
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