Response from WA Country Mental Health Services
Section 1: National Mental Health Care Type
Is a Mental Health Care Type the best way of
encompassing those admitted services that should form
part of a new national mental health classification?
Yes Mental Health Care Type is the best way. Care type should be tracked by patient treatment, not
bed type, as these do not always match. If the principle diagnosis is for a medical condition there
needs to be acknowledgement of the patients mental health issue.
Separate way of doing business for mental health. There could be three care types; acute, sub acute
and rehabilitation. Acute mental health care is sufficiently different to other acute care types.
We should be driven by patient care rather than a funding model
The Mental Health Commission are funding NGO’s to provide sub acute care programs
Section 2: Establishing criteria for the definition of services within a national mental health Care
Type
What should be the criterion, or criteria, for the definition of services within a national mental
health Care Type?
The definition should be based on receiving treatment from a specialised mental health unit,
team or provider. A specialist mental health team treating a patient within a general ward
would be in scope. Consultation liaison services provided by Community MH services into
hospital Emergency Departments and general wards need to be in scope. In WA country
Health approximately 80% of mental health activity occurs in the general setting with
specialist mental health inreach for assessment and treatment.
The criteria should be that all patients with a primary or secondary mental health diagnosis
(ICD 10 or DSM) be the care type as defined and be costed to specialist mental health services
Section 3: Applying the definition of ‘mental health services’ to community-based mental health
services
What community-based mental health services should be defined as mental health services
for casemix classification purposes?
All Community mental Health services providing specialist care to people in emergency
departments and general wards.
Section 4: Defining primary mental health services delivered by public hospitals
Are there any services that are provided by specialised
mental health units or programs that can be considered
primary mental health?
In WA country mental health the boundaries between specialised and primary mental health care can
be very blurred and specialist services work very closely with G.Ps. Specialist mental health services
can provide primary mental health assistance for high prevalence disorders such as ‘situational crisis’
, relationship issues, drug and alcohol problems, seasonal crisis etc.
Section 5: Services for people whose primary problem is an alcohol or drug-related disorder
Should the mental health classification include alcohol
and drug-related disorders? Is it the diagnosis or
specialised treatment setting that is used as the decisive
criterion for inclusion in the definition?
This is a very complex issue. For WA country health we provide services to both. Mental Health
services treat all comorbid disorders including drug and alcohol. Detox is often provided in general
hospitals with specialist input. Drug and Alcohol services are also funded separately and MOU’s
between MH and DAO services are in place to ensure a no wrong door approach.
Section 6: Classifying specialised ‘non-acute’ bed-based mental health services
Should long-term non-acute bed-based clinically-staffed
mental health public hospital services be classed as
residential, admitted mental health or admitted
maintenance care?
Residential services in WA country regions are provided by NGOs. The specialist mental health clinical
inreach provided to those in residential facilities should be in scope.
Section 7: Setting the boundary with aged inpatient Care Types
Should the Psychogeriatric Care Type continue to exist or
should all of the mental health care of older people be
defined as Mental Health for classification purposes?
WA Country mental health services do not have dedicated older persons mental health beds. We do
provide mental health consultation liaison to geriatric wards and aged care facilities. There is a
visiting Psychogeriatric service currently in place via the schedule C sub acute intiative.
Section 8: Emergency department care for patients with a mental disorder
Should mental health care in the emergency department
(ED) be defined as ED or Mental Health for classification
purposes?
WA Country mental health services provide extensive psychiatric consultation liaison in our EDs .
However only 3 regions have dedicated C/L clinicians all other mh services to Ed are provided by our
community MH services on an ad hoc basis. The service and activity they generate should attract
additional funding. If a MH C/L team has been in contact with the patient in Ed it should be defined as
mental Health. If there is no contact with Mh service it should be defined as ED. There is still a grey
area around how ED patients should be classified
If mental health encompasses emergency department care services, how should these
services be classified (e.g., diagnosis based on MDCs?)
Diagnosis based on MDCs
Section 9: Jurisdictional differences in the reporting of mental health services in the mental health
patient-level NMDSs
Section 10: New data elements needed in current NMDSs to enable the development and
implementation of a mental health service classification framework
How should current mental health NMDSs be adapted to facilitate the implementation of a
mental health service classification without adding to the data collection burden that services
and clinicians currently face?
The classification should reflect the clinical input. Clinicians inputting data should never
compromise clinical care
Section 12: Other
Any other issues