Paget Michael Creelman, CC BY-SA 4.0, via Wikimedia Common


by Dr Nathan Kesteven

There have been some great local improvements regarding mental health services, with Healthy North Coast introducing a raft of options for a wide range of patients with mental health conditions (see below). Coupled with this there are now several Telehealth services that can provide practices with access to not only psychiatric services but nearly all other medical specialties (see list below), with these services generally bulk-billed and often able to be delivered to the patient at home.

Some 24 years ago my sister died as a result of a severe mental health condition. At the time there did not exist any well coordinated outreach services, with acute services only at Richmond Clinic, Lismore Base Hospital.

Now at the Base, there are not only acute adult mental health services (Tallowwood) available  but also the Child  and Adolescent inpatient facility (Kamala) and the Older Persons Mental Health Unit (Lillipilli). Just as importantly, Byron Shire  Hospital hosts the Tuckeroo Adult sub-acute unit, which offers care for those with mild/moderate mental health conditions. (See below for contact details.)

Coupled with these are the Community Mental Health Services (02) 6639 9400, which come into play in acute situations and offer ongoing outpatient support and admission if needed. Plus there is the Mental Health Line on 1800 011 511 for immediate support when needed.

Healthy North Coast has put together a raft of support and therapeutic options, which are listed on their website.

The site also hosts support for the NDIS and Drug and Alcohol Services.

The number of options and supports that are available via this PHN service is fantastic (at least by my measure) and well overdue. They are all free and easily accessible. 

For instance, the Low Intensity Mental Health Service offers quick access for providers for those who need low level mental health support while they are awaiting more formalised help, for example from a psychologist. This service is based on the Cognitive Based Therapeutic approach and given by trained therapists (though not clinical psychologists). There exists a dedicated Aboriginal/TSI service under this program as well.

While the Healthy Minds Suicide Preventions Service has an average wait time of six days, if the patient needs immediate help this is available via the Mental Health Line/Emergency services.

The one service that is, to my mind, a great addition is the Complex and Severe Mental Health Service, with services provided by credentialed Mental Health Nurses that include care coordination, psycho-education, motivational interviewing, support with mental health medication management, mental state examinations and identification of and connection to treatment for co-existing physical challenges. 

The Service also supports and refers clients to providers of psychosocial services and where appropriate supports clients to apply for the NDIS. The average wait time for the Service is 20 days.

The LHD/inpatient service and Acute Care Team, as well as GPs, can refer directly to a credentialed Mental Health Nurse contracted to the Service or can refer via Connect to Wellbeing North Coast (intake, assessment & referral service).

Importantly, patients under this service can access the Commonwealth Psychological Support Program (CPS), the aim of which is  to assist those in the community with moderate to severe mental health to access a broad range of person-centred activities to address psychosocial impacts. 

The program aims to:

  • increase functional capacity to live independently in the community.
  • reduce the need for acute mental health services.
  • increase connection and reduce isolation.
  • increase knowledge and skills.
  • increase engagement in daily activities, relationships, and the community.
  • improve or stabilise mental health and wellbeing.
  • improve self-confidence and independence.
  • move towards personal recovery goals.
  • support access to appropriate supports, including the NDIS where appropriate. 

CPS is provided through the following agencies – The Buttery, Mission Australia, Chess Connect and Momentum Collective. There is currently an average of a four-week wait to access these supports. The LHDs are increasing their referrals to the program, as the criteria changed for three of the four agencies to enable acceptance of new referrals from July 2021.

As well the GP Psychiatry Support Line has been commissioned by a number of PHNs, including Healthy North Coast, to assist GPs with care of mental health consumers. GPs use the line to speak directly to a psychiatrist for advice on:

  • Diagnosis
  • Investigation
  • Medication
  • Safety plans

In the first year of operation (2019/20), 96% of calls to the line were about medication. Survey respondents reported a high level of satisfaction with the advice.

The GP Psychiatry Support Line also offers four webinars with Professor Martin Cohen and invited psychiatrists (see individual links in starting points below). The topics, which have been confirmed as most common by research, are based on feedback from GPs and the community.

Finally the PHN is working on a web-based database of psychologists and counsellors in the Northern Rivers. This database, soon to be launched, will not only highlight the particular interest of that psychologist/counsellor but also have information regarding their availability. This is a wonderful step forward and will help both practitioners and patients in allowing for more timely and effective delivery of mental health services. Watch this space…

Resources

Northern NSW LHD

Primary Health North Coast

Telehealth Services Accessible via Medicare Bulk Billing: