The role of primary care mental health nurse practitioners in Australia

Abstract

The Tristar Medical Group use Mental Health Nurse Practitioners (MHNPs) to both provide and co-ordinate care. Completion rates of entire 90-day cycles of care and review of GPMHCPs sits at approximately 70%, which is significantly better than the National average of 42% since the introduction of the MBS 2712 billing item. This item itself is integral in demonstrating effectiveness in reviewing planned care. The role of the MHNP has been vital to achieving excellent patient care outcomes in this domain. MHNPs value add into Primary Care and General Practice by: • Advanced assessment and diagnosis of Mental Health Issues • Monitoring physical health, • Ordering and analysing tests • Prescribing medications, • Providing psychoeducation for medication adherence • Psychotherapy / Psychological Interventions • Monitoring and reporting all aspects of care to the Treating Team Participants in this evaluation believe that Mental Health Nurse Practitioners (MHNP) provide the maximum value for clinical care across the entire biopsychosocial Model. Clients receiving treatment and support by MHNPs experienced improved outcomes through increased continuity of care- including through home visits, follow up and care co-ordination, access to support and greater compliance with their treatment plans. Care provided by MHNPs demonstrated evidence of an overall reduction in hospital admission rates and lengths of stay in hospital where admission occurred; increased levels of employment; improved family and community connections; and positive impacts on GP workloads. Evidence of effectiveness of the MHNP model of service delivery whereby MHNs were actively providing clinical interventions and co-ordinating care for patients is well supported by the results of this evaluation. If the business model and funding changed, more MHNPs could be recruited, especially given the scarcity of other mental health clinical discipline in rural communities. Current funding for MHNPs has been restricted to those who receive PHN subsidy under the stepped care model. This limits the opportunity to provide the full range of care that MHNPs are capable of delivering compared to other clinical disciplines. Submissions to government to facilitate greater access to MBS items for their services is recommended