There is often confusion about whether a patient is eligible for a Mental Health Treatment Plan (MHTP). Questions arise as to whether they have a mental disorder. The following information has been collated to assist GPs in determining a patients eligibility for a MHTP.
Definition of Mental Disorder
The Medicare Benefits Schedule (MBS) defines Mental Disorder for the purposes of psychological treatment as the following:
A mental disorder may be defined as a significant impairment of an individual’s cognitive, affective and/or relational abilities which may require intervention and may be a recognised, medically diagnosable illness or disorder – this definition is informed by the World Health Organisation, 1996, Diagnostic and Management Guidelines for Mental Disorders in Primary Care:ICD – 10 Chapter V Primary Health Care Version.
Dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders for the purposes of these items.
The MBS does not clearly state that there MUST be a diagnosable mental disorder in order to write a MHTP. However, if a GP wishes to make a diagnoses for the purpose of writing a MHTP, the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) has particular diagnostic categories that may help.
DSM 5 Diagnoses
Diagnoses from DSM 5 that apply “to presentations in which symptoms characteristic of [the]… disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the … diagnostic class. The unspecified … disorder category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific … disorder, and includes presentations for which there is insufficient information to make a more specific diagnosis (e.g., in emergency room settings).”
- Unspecified Depressive Disorder
- Unspecified Anxiety Disorder
- Unspecified Bipolar Disorder
- Unspecified Obsessive Compulsive Disorder
- Unspecified Trauma – and Stressor-Related Disorder (i.e. PTSD, adjustment disorder, reactive attachment disorder
- Unspecified Dissociative Disorder
- Unspecified Schizophrenia Spectrum and Other Psychotic Disorder
- Unspecified Neurodevelopment Disorder (ADHD, Autism, Learning Disorder)
- Unspecified Somatic Symptom and Related Disorder
- Unspecified Feeding and Eating Disorder (Anorexia, Bulimia, Binge-Eating, Pica)
- Unspecified Insomnia/Hypersomnolence/Sleep-Wake Disorder
- Unspecified Sexual Dysfunction
- Unspecified Gender Dysphoria
- Unspecified Substance-Related Disorder