S.TRUEMAN PhD THESIS 2016

66

Table 2.16 Medicare-subsidised mental health and related services: user rates per 1,000 population, 1 July 2007 to 30 June 2011

Major Cities

Remote

Very Remote

GP CP

79

25

8 0

5

0

CP-291

0.3

0.0

0.0

CP+ PTS

92 52

4 5

2

2 GP: General practitioner mental health services created or significantly altered by Better Access to Mental Healthcare services. CP: Consultant psychiatry items created or significantly altered by Better Access. CP-291: Initial assessment for a GP-shared care plan by a psychiatrist (MBS item no. 291). CP+: All/most psychiatry items. PTS: Psychological therapy provided by a clinical psychologist. This study demonstrates that macro- and meso-targeted interventions, designed with the best of intentions as ‘levers’ for change in remote areas, need to be more nuanced than those conducted to date. With reference to Table 2.16, the Better Access measures have produced no discernible change to the lack of psychiatric services in remote areas. This is consistent with previous studies that have found that the lowest levels of available psychiatric services are in remote areas (Meadows, Singh, Burgess & Bobevski, 2002). This is an example of the need for the National Mental Health Commission’s (2014) Recommendation 10: rather than a ‘one-size-fits-all’ approach, sustained funding must be targeted, specific and localised.