How acceptable are one-off consultations for consumers? Further information on Item 291

Abstract

Objective: The aim of this paper is to evaluate consumer and carer views of one-off psychiatric assessments, Item 291 in the Australian Medicare system. Method: Following general practitioner referral to a psychiatrist, consumers were invited to enrol in this study and provide: demographic data; a one-off face-to-face recorded interview 6–8 weeks following psychiatric assessment; and longitudinal assessment of their mental health, using the DASS, K10 and WHOQoL (prior to psychiatric assessment, 6–8 weeks after assessment and 3–4 months later). Results: Consumer and carer enrolment were very difficult to obtain. Sufficient consumers (8) enrolled to provide meaningful qualitative data. Most had good mental health literacy, had severe and chronic mental health problems, and appreciated the opportunity to access a mental health expert and receive a management plan. Overall, GPs had appropriately informed consumers of the process. Following assessment, the GP and consumer were implementing the suggested management plan. Negative statements included instances of failure to improve, insufficient appointments with the psychiatrist, and concern with GP follow-up. Conclusion: One-off psychiatric assessments using Item 291 appear highly acceptable to referred consumers. Qualitative outcomes showed trends towards an improvement in mental health, in an appropriate target group.