Telehealth is changing ‘devastating’ for psychiatric patients in regional regions | Health

Australians in regional areas with serious mental health problems will be left helpless after “devastating” changes to the telehealth system, psychiatrists warn.

Recent federal government reforms have removed a 50% charge for some rural psychiatric services, meaning that certain types of consulting service providers will no longer be able to bill in bulk. They will have to absorb the costs or pass them on to the patients.

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Dr Vivienne James, a psychiatrist at the Gordon Clinic in Sydney, says she is “devastated” and her patients will be “distressed” by the changes, which took effect on January 1.

“It’s just not financially viable for us to continue seeing these patients,” she said.

“This will leave a lot of patients in distress and dare I say it suicidal, as some of these people are extremely isolated and have little support. They will not be able to pay to see us and will have to be sent back to their GP.

“Personally, I am devastated by these changes. “

Grahame Gee, a registered mental health nurse, said it was “unethical” that he and his colleagues were “blinded” by the changes, which were announced weeks before Christmas. Her patients have complex mental health needs and many also have a history of physical and sexual abuse and spousal abuse.

“Most have limited financial means and find it difficult to pay the gap fees,” he said.

“Their recovery depends on having access to this service … I have had patients in tears … Others have said they should cancel their appointments.”

On December 13, the federal Department of Health announced $ 106 million to make telehealth a permanent part of primary health care. On December 16, he announced changes to the Medicare plan, including two new telehealth features, 17 changed items and the removal of 128 items including item 288 for video psychiatric consultations via GP referrals. .

Guardian Australia has revealed how other changes would affect patients, especially those with cancer.

Assoc Prof Vinay Lakra, president of the Royal Australian and New Zealand College of Psychiatrists, said most of the reforms were welcome, but correcting some shortcomings meant others had emerged.

“People living in a rural area could not afford to see a psychiatrist, but [the rural loading] allowed them to see a psychiatrist without paying a gap. If you do bulk billing and the charge is removed, some providers will pass the cost on to patients and patients may cancel their appointment.

Rural charging was introduced around 10 years ago to encourage the use of telehealth in Australia, an incentive which the Department of Health says is no longer needed.

Lakra said that before Covid, the psychiatric community wanted it to be done away with rather than removed and only removed if there was another system in place to ensure affordability and accessibility. Covid “is not gone,” he said, and the college wants the MBS element to be extended for one year.

“Twelve months is enough time to prepare a plan… With point 288, there was not enough time,” he said.

In a statement, the health ministry said the new agreements consolidate telehealth into one national program, “ensuring universal and equitable access,” and that rural patients will have access to other pooled billing options.

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The charge was to encourage the use of video consultations and help practitioners adopt new technologies. But according to the statement, there are about 10 times as many phone consultations as there are views that attract the load and more than twice as many video views that do not attract the load.

“This is about improving access to video and telephone services provided by general practitioners, medical specialists and other health professionals which reflect best clinical practices and offer greater flexibility to the health system, depending on of the services required, “the statement read.

“It is supported by an additional $ 106 million over four years and is part of a government investment of $ 308.6 million to support Australia’s primary care system.”

The crisis assistance services are available 24 hours a day: Lifeline 13 11 14; Suicide reminder service 1300 659 467; Child helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond the Blue 1300 22 4636

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