Lessons from billed telepsychiatry in Australia during the COVID-19 pandemic: rapid adaptation to increase specialist psychiatric care

Jeffrey Looi; Tarun Bastiampillai; William Pring; Rebecca Reay; Stephen Kisely; Stephen Allison

doi:10.1071/phrp3242238

RESEARCH ARTICLE (Open Access)

Lessons from billed telepsychiatry in Australia during the COVID-19 pandemic: rapid adaptation to increase specialist psychiatric care

Jeffrey Looi ^A ^B ^C ^* , Tarun Bastiampillai ^C ^D ^E , William Pring ^C ^E ^F ^G , Rebecca Reay ^A , Stephen Kisely ^C ^H ^I and Stephen Allison ^C ^D

+ Author Affiliations

- Author Affiliations

^A Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, ACT

^B Private psychiatrist, Canberra, ACT, Australia

^C Consortium of Australian Academic Psychiatrists for Independent Policy Research and Analysis, Canberra, ACT

^D College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia

^E Department of Psychiatry, Monash University, Melbourne, VIC, Australia

^F Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia

^G Private psychiatrist, Melbourne, VIC, Australia

^H School of Medicine, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia

^I Departments of Psychiatry, Community Health and Epidemiology, Dalhouise University, Halifax, Nova Scotia, Canada

^* Correspondence to: jeffrey.looi@anu.edu.au

Public Health Research and Practice 32, e3242238 https://doi.org/10.17061/phrp3242238

Published: 13 December 2022

2022 © Looi et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

Abstract

Objective:To summarise and comment upon research regarding the service delivery impact of the introduction of COVID-19 pandemic Medicare Benefits Schedule (MBS) psychiatrist telehealth services in Australia in 2020–2021. Type of program or service: Privately-billed, MBS-reimbursed, face-to-face and telehealth consultations with a specialist psychiatrist during the first year of the COVID-19 pandemic. Methods: This paper draws on analyses of previously published papers. MBS-item-consultation data were extracted for video, telephone and face-to-face consultations with a psychiatrist for April–September 2020 in Victoria, and compared to face-to-face consultations in the same period of 2019 and for all of Australia. We also extracted MBS-item-consultation data for all of Australia from April 2020–April 2021, and compared this to face-to-face consultations for April 2018–April 2019. Results: Although face-to-face consultations with psychiatrists waned following nationwide lockdowns, the introduction of MBS billing items for video and telephone telehealth meant that overall consultations were 13% higher in April 2020–April 2021, compared to the pre-pandemic year prior. A lockdown restricted to Victoria was associated with a 19% increase in consultations from April-September 2020, compared to the corresponding period in 2019. Lessons learnt: Telehealth has been an integral component of Australia’s relatively successful mental health response to COVID-19. The public availability of MBS data makes it possible to accurately assess change in psychiatric practice. T–e Australian Federal Government subsidises MBS telepsychiatry care by a patient rebate per consultation, illustrating that government-subsidised services can rapidly provide additional care. Rapid and substantial provision of telepsychiatry in Australia indicates that it may be a useful substitute or adjunct to face-to-face care during future pandemics and natural disasters.