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Objective: To provide a rapid clinical update on casemix, average length of stay, and the effectiveness of Australian private psychiatric hospitals.Methods: We conducted a descriptive analysis of the publicly available patient data from the Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service website, from 2015-2016 to 2019-2020. This was compared with corresponding reporting on public and private hospitals from the Australian Institute of Health and Welfare, and Australian Mental Health Outcomes and Classification Network.Results: In 2019-2020, there were 72 private psychiatric hospitals in Australia with 3582 acute beds. There were 42,942 inpatients with 1,286,470 days of care, and a mean length of stay 19.6 days (SD 13.9) for the financial year 2019-2020. The main diagnoses were major affective and other mood disorders (49%), and alcohol and other substance abuse disorders (21%). Clinician-rated outcome measures, that is, the HoNOS, showed an improvement effect size of 1.64, while the patient-rated MHQ-14 showed an improvement effect size of 1.18. Results are similar for previous years.Conclusions: Private psychiatric hospitals provide substantial, effective psychiatric care. [ABSTRACT FROM AUTHOR]

Objective: To provide reflection on career opportunities, benefits and challenges, with regard to commencing private practice psychiatry in Australia. Conclusions: There are varied opportunities for a career in private practice psychiatry. Private practice has benefits and challenges, distinct from public sector psychiatry; with moderately greater professional autonomy, facilitating the provision of expert mental healthcare for the community. [ABSTRACT FROM AUTHOR]

Objective: To provide a clinical update on private health insurance in Australia and outline developments in US-style managed care that are likely to affect psychiatric and other specialist healthcare. We explain aspects of the US health system, which has resulted in a powerful and profitable private health insurance sector, and one of the most expensive and inefficient health systems in the world, with limited patient choice in psychiatric treatment. Conclusions: Australian psychiatrists should be aware of changes to private health insurance that emphasise aspects of managed care such as selective contracting, cost-cutting or capitation of services. These approaches may limit access to private hospital care and diminish the autonomy of patients and practitioners in choosing the most appropriate treatment. Australian patients, carers and practitioners need to be informed about the potential impact of private managed care on patient-centred evidence-based treatment. [ABSTRACT FROM AUTHOR]

Objective: This opinion paper discusses certain recommendations of the House of Representatives Select Committee on Mental Health and Suicide Prevention pertaining to psychology, GP and psychiatric professions. Conclusions: The Committee's recommendations may compromise patient care by undermining the ability of private sector medical specialists in providing direct clinical treatment and their role in the coordination of multidisciplinary teams. Expanding private psychological therapies without GP and private psychiatry support might increase the reliance on public hospital emergency departments and public sector mental health services for severe disorders and suicidal crises. Psychiatrists and GPs need to engage in more effective policy advocacy with the Australian Government, in order to maintain their roles in leading private sector collaborative multidisciplinary care. [ABSTRACT FROM AUTHOR]

Objective: The Australian Federal government introduced new COVID-19-Psychiatrist-Medicare-Benefits-Schedule (MBS) telehealth-items to assist with providing private specialist care. We investigate private psychiatrists' uptake of telehealth, and face-to-face consultations for April–September 2020 for the state of Victoria, which experienced two consecutive waves of COVID-19. We compare these to the same 6 months in 2019. Method: MBS-item-consultation data were extracted for video, telephone and face-to-face consultations with a psychiatrist for April–September 2020 and compared to face-to-face consultations in the same period of 2019 Victoria-wide, and for all of Australia. Results: Total Victorian psychiatry consultations (telehealth and face-to-face) rose by 19% in April–September 2020 compared to 2019, with telehealth comprising 73% of this total. Victoria's increase in total psychiatry consultations was 5% higher than the all-Australian increase. Face-to-face consultations in April–September 2020 were only 46% of the comparative 2019 consultations. Consultations of less than 15 min duration (87% telephone and 13% video) tripled in April–September 2020, compared to the same period last year. Video consultations comprised 41% of total telehealth provision: these were used mainly for new patient assessments and longer consultations. Conclusions: During the pandemic, Victorian private psychiatrists used COVID-19-MBS-telehealth-items to substantially increase the number of total patient care consultations for 2020 compared to 2019. [ABSTRACT FROM AUTHOR]