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Objective: Two pivotal Australian Government primary mental health reforms are the Access to Allied Psychological Services (ATAPS) projects, introduced in July 2001 and implemented by Divisions of General Practice, and the Better Access to Psychiatrists, Psychologists and GPs through the Medicare Benefits Schedule (Better Access) programme, introduced in November 2006. This research explores the reciprocal impact of the uptake of psychological treatment delivered by these two initiatives and the impact of location (rurality and socioeconomic profile) on the uptake of both programmes since the inception of the Better Access programme. ATAPS session delivery, before and after the introduction of the Better Access program, is also examined. Method: General Practice Division-level data sources included a minimum dataset containing uptake data of ATAPS services, Medicare Benefits Schedule uptake data supplied by the Medicare Benefits Branch of the Department of Health and Ageing, a Rural, Remote and Metropolitan Area classification, and Indices for Relative Socio Economic Disadvantage (IRSD). Regression analyses were conducted to examine the reciprocal impact of the two programmes and the impact of rurality and socioeconomic status up to December 2008. Results: A dramatic uptake of Better Access sessions, particularly in urban areas, coincided with a temporary reduction in sessions provided under ATAPS, with an overall small positive relationship detected between the two programmes. A greater proportion of ATAPS sessions (45%) have been delivered in rural areas compared with Better Access (18%). The combination of socioeconomic profile, rurality, and Better Access sessions accounted for a small but significant percentage of variance (7%) in the number of ATAPS sessions delivered, with a non-significant independent contribution of Better Access sessions to the prediction of ATAPS sessions. Weak but significant relationships between ATAPS sessions and each of socioeconomic profile ( r = 0.22) and rurality ( r = −0.24), respectively, were identified. In comparison, socioeconomic profile, rurality, and ATAPS sessions accounted for a much larger and significant percentage of variance (46%) in number of Better Access sessions delivered, with a non-significant independent contribution of ATAPS sessions to the prediction of Better Access sessions. Moderate significant relationships between Better Access sessions and each of socioeconomic profile ( r = 0.46) and rurality ( r = −0.66), respectively, were identified. The introduction of Better Access appears to have halted the steady increase in the number of ATAPS sessions previously observed. This finding should be interpreted alongside the fact that ATAPS funding is capped. Conclusions: The findings are policy relevant. ATAPS projects have been successfully providing equity of geographic and socioeconomic access for consumers most in need of subsidized psychological treatment. The uptake of psychological treatment under Better Access has been dramatic, suggesting that the programme is addressing an unmet need. [ABSTRACT FROM AUTHOR]

Background: The Australian Better Outcomes in Mental Health Care (BOiMHC) program commenced in 2001, with the aim of improving primary mental healthcare delivery. One component of the BOiMHC program involves 108 Access to Allied Psychological Services (ATAPS) projects which enable GPs to refer patients to allied health professionals for low-cost, evidence-based care. The projects have improved access to psychological care, but referrals are outstripping their capacity to provide psychological services. This study examined the demand management strategies that projects have used, and how well these strategies are working. Method: A survey was emailed to the project officers of the 108 ATAPS projects. Results: The most commonly used demand management strategies were: informing/training GPs; putting in place systems and/or administrative procedures; and monitoring and limiting referrals. Most projects used combined broad demand management strategies, employing many approaches within each strategy. Monitoring and limiting referrals and putting in place systems and/or administrative procedures were ranked as the most useful. Demand strategies were underpinned by strong partnerships and solid infrastructure. Conclusion: The ATAPS projects are using demand management strategies. Strategies tend to be supply-side strategies instituted where the patient makes contact with the GP and/or approaches the GP-allied health professional interface, rather than demand-side strategies aimed at the patient-practice interface. Strategies appear to be working well when supported by collaborations and infrastructure. The need for demand management strategies reflects resourcing issues that impact on providers' morale and patients' satisfaction. Findings are discussed in relation to other recent developments in Australian primary mental healthcare. [ABSTRACT FROM AUTHOR]