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Mental health care plan - who can see it?


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#1 flowermama

Posted 23 May 2019 - 08:50 PM

I posted over a year ago about a good friend whose husband wanted to leave her. 16 months on, he's still there but things have been awful - he was having an emotional relationship with an ex-colleague who lived interstate (otherwise I'd say it also would have been physical). He has treated my friend appallingly and blamed her for everything he does, threatened to leave her every time she tried to discuss his behaviour, insulted her and put her down, comparing her unfavourably to his girlfriend. She also found out he's been buying cocaine on his nights out when he finally gets home at 6am. She's emotionally destroyed and her eldest child has been affected by what he's seen and heard but she's insistent that she won't be the one to break up the family (believe me, I've tried everything I can and so has her family to get her to see that he's the one breaking things up and at this point there's nothing left to be salvaged). I'm trying to convince her to get a mental health care plan and see a psychologist but she's too embarrassed to go to her regular GP. Is she able to go to a different GP for a mental health care plan and if so, is this information shared with her regular GP? She opted out of having a My Health Record. I've told her she has no reason to be embarrassed but she's adamant she won't go to her usual GP and will only go if she can be sure it can be kept separate from the rest of her medical information. I just want her to get some help as nothing I say seems to get through to her and she can't go on like this. We live in different states so I can't even really be there to support her but I hate how much pain she's in :( Thanks in advance.

#2 ilovethebeach

Posted 23 May 2019 - 09:40 PM

She can go to a different gp & her regular gp won't see it.

#3 flowermama

Posted 23 May 2019 - 09:49 PM

View Postilovethebeach, on 23 May 2019 - 09:40 PM, said:

She can go to a different gp & her regular gp won't see it.

Great! Thanks so much, hopefully that will convince her to see someone.

#4 Pearson

Posted 24 May 2019 - 03:37 PM

That's terrible. Can you contact DOCS or something so that they can keep an eye on the child?
So hard when they can't see that they are a victim.

#5 ECsMum

Posted 24 May 2019 - 03:40 PM

One thing I have just learnt that if you are put on a mental health care plan it must be disclosed as a pre-existing condition - for things like health insurance and job applications (if asked).

#6 lizzzard

Posted 24 May 2019 - 04:22 PM

In her shoes I would want assurance from a credible/ formal source regarding the confidentiality of the care plan. Perhaps suggest that she could always go to a GP at a medical centre and ask first, without disclosing anything, whether anything she tell them would be disclosed to anyone, including her regular GP. If they say yes for some reason she can always walk right out! But I’m sure the answer is no as well.

#7 Veritas Vinum Arte

Posted 24 May 2019 - 04:35 PM

View PostECsMum, on 24 May 2019 - 03:40 PM, said:

One thing I have just learnt that if you are put on a mental health care plan it must be disclosed as a pre-existing condition - for things like health insurance and job applications (if asked).

How long is this disclosure applicable for? Eg Primary child does MHCP do they have to disclose for life?

#8 YodaTheWrinkledOne

Posted 24 May 2019 - 04:47 PM

View PostECsMum, on 24 May 2019 - 03:40 PM, said:

One thing I have just learnt that if you are put on a mental health care plan it must be disclosed as a pre-existing condition - for things like health insurance and job applications (if asked).
Using a mental health care plan is not a diagnosis. People can use a mental health plan for all kinds of problems, it is not in itself a diagnosis of anything.

However, if you have been formally diagnosed with a mental health condition that is specifically identified in an insurance application (eg. In the past five years, have you been diagnosed or treated for any of the following conditions:  depression, bipolar, etc) then yes, you need to disclose it. Often they will ask when did you last have treatment and that will influence whether it's included or not.

I would *never* disclose my health condition in a job application unless I was offered the job. And even then, I am not sure I would.

#9 QuirkyMum

Posted 24 May 2019 - 04:49 PM

Just saying that it will be recorded in her Medicare history under certain Medicare item (health care plan specific probably).
I wonder who should be able to access your Medicare history. Technically doctors shouldn't be able to see what you claimed throughout the year. But I had 5 different times different specialists mentioned that I've seen other doctors ( different specialist areas of medicine for second and third opinion, not in the same practice, actually 50 km away - quite far for Sydney). I was being honest about second and third opinions in both cases and both time original and third doctors knew, nodded and gave me names before I could articulate.

#10 YodaTheWrinkledOne

Posted 24 May 2019 - 04:53 PM

View PostQuirkyMum, on 24 May 2019 - 04:49 PM, said:

Just saying that it will be recorded in her Medicare history under certain Medicare item (health care plan specific probably).
I wonder who should be able to access your Medicare history. Technically doctors shouldn't be able to see what you claimed throughout the year. But I had 5 different times different specialists mentioned that I've seen other doctors ( different specialist areas of medicine for second and third opinion, not in the same practice, actually 50 km away - quite far for Sydney). I was being honest about second and third opinions in both cases and both time original and third doctors knew, nodded and gave me names before I could articulate.
did you have the same referral doctor? They can disclose prior medical information when they write up a referral.

#11 mayahlb

Posted 24 May 2019 - 05:30 PM

View PostECsMum, on 24 May 2019 - 03:40 PM, said:

One thing I have just learnt that if you are put on a mental health care plan it must be disclosed as a pre-existing condition - for things like health insurance and job applications (if asked).

I don't think this is accurate. A mental health plan is not a diagnosis or condition. People seek help from psychologists for all sorts of reasons, I saw one after my mother died and again when I was struggling as a carer for two children with diagnosed conditions.

Now if it was an actual health condition then yes I *may* be required to mention it during a job application but it is private information and I'm pretty sure unless it specifically relates to the job you are under no obligation to mention it. Maybe if it is a recognized disability then you might mention it when accepting the job, but having to state it during the job application opens up all sorts of issues with potential discrimination, etc.

Health insurance, I'm not so sure. They ask questions at times that you are not actually legally obliged to provide information for, so that is skirting the issue.

On the original question I don't think her original GP would be able to see it. The question would only arise if she went to get a new mental health care plan with her normal GP and it was knocked back. It sounds like a terrible situation for both your friend and her son and I hope that accessing some psychological help will allow your friend to do something about changing the situation.

Edited by mayahlb, 24 May 2019 - 05:32 PM.


#12 Cimbom

Posted 24 May 2019 - 05:37 PM

You don't have to disclose any medical information in a job application or employment medical. The risk is that if you don't mention it then you may not be able to claim workers compensation or the like if something happens that's linked to it but if you're comfortable with that risk then you're not obliged to say anything.

#13 flowermama

Posted 24 May 2019 - 09:10 PM

Thanks for the replies. That puts a different spin on things, I don’t think she’d be comfortable with it being recorded in her Medicare history. She might be better to see someone privately if she can manage it financially.

#14 YodaTheWrinkledOne

Posted 24 May 2019 - 09:39 PM

View Postflowermama, on 24 May 2019 - 09:10 PM, said:

Thanks for the replies. That puts a different spin on things, I don’t think she’d be comfortable with it being recorded in her Medicare history. She might be better to see someone privately if she can manage it financially.
If it's claimed as a medicare item, it's a record in Medicare, either by a GP (who claims a referral for a mental health care plan) or by the specialist (who claims for a actual mental health care plan consultation).

If anyone does have access to Medicare data, they would need to be able to identify the actual medicare item. (Medicare is basically an invoicing system for the government where consultations are billed using item numbers.) There are a few different numbers for mental health care plans and actual consultations.

#15 CallMeFeral

Posted 24 May 2019 - 09:50 PM

View PostYodaTheWrinkledOne, on 24 May 2019 - 04:47 PM, said:

Using a mental health care plan is not a diagnosis. People can use a mental health plan for all kinds of problems, it is not in itself a diagnosis of anything.

Isn't a diagnosis required though for eligibility for a rebate for psych services? I mean I know it's not always done but I thought technically a 'mental disorder' is a requirement.

View Postflowermama, on 24 May 2019 - 09:10 PM, said:

Thanks for the replies. That puts a different spin on things, I don’t think she’d be comfortable with it being recorded in her Medicare history. She might be better to see someone privately if she can manage it financially.

Yep, if she can see someone privately she wouldn't have to even give them a correct name. She could be totally incognito.

#16 teaspoon

Posted 24 May 2019 - 10:03 PM

View PostCallMeFeral, on 24 May 2019 - 09:50 PM, said:

Isn't a diagnosis required though for eligibility for a rebate for psych services? I mean I know it's not always done but I thought technically a 'mental disorder' is a requirement.

No, a diagnosis isn't required. A person could be distressed about a life event and in need of psychological support. Distress isn't a diagnosis.

#17 CallMeFeral

Posted 24 May 2019 - 10:27 PM

View Postteaspoon, on 24 May 2019 - 10:03 PM, said:

No, a diagnosis isn't required. A person could be distressed about a life event and in need of psychological support. Distress isn't a diagnosis.

While it is true they may need psychological support, and most GP's unofficially practice this way, distress does not technically fulfil the requirements to get you a mental health care plan under the rules.


https://www.health.g...lth-care-pdf-qa

1.6 What is considered a mental disorder for the purposes of these items?

The GP Mental Health Treatment items are for patients with a mental disorder who would benefit from a structured approach to the management of their care needs. Mental disorder is a term used to describe a range of clinically diagnosable disorders that significantly interfere with an individual’s cognitive, emotional or social abilities.

This list of mental disorders is informed by the World Health Organisation, 1996, Diagnostic and Management Guidelines for Mental Disorders in Primary Care: ICD-10 Chapter V Primary Care Version.

Dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders for the purposes of the GP Mental Health Treatment items.

Edited by CallMeFeral, 24 May 2019 - 10:30 PM.


#18 WaitForMe

Posted 24 May 2019 - 10:43 PM

View Postmayahlb, on 24 May 2019 - 05:30 PM, said:

I don't think this is accurate. A mental health plan is not a diagnosis or condition. People seek help from psychologists for all sorts of reasons, I saw one after my mother died and again when I was struggling as a carer for two children with diagnosed conditions.

Now if it was an actual health condition then yes I *may* be required to mention it during a job application but it is private information and I'm pretty sure unless it specifically relates to the job you are under no obligation to mention it. Maybe if it is a recognized disability then you might mention it when accepting the job, but having to state it during the job application opens up all sorts of issues with potential discrimination, etc.

Health insurance, I'm not so sure. They ask questions at times that you are not actually legally obliged to provide information for, so that is skirting the issue.

On the original question I don't think her original GP would be able to see it. The question would only arise if she went to get a new mental health care plan with her normal GP and it was knocked back. It sounds like a terrible situation for both your friend and her son and I hope that accessing some psychological help will allow your friend to do something about changing the situation.

Health insurance they wont ask as it is regulated in Australia to ensure the fee is 'universal' - they cant consider pre-existing conditions, they just give waiting periods.

Life insurance, and probably disability etc, yep they can most definitely ask!

I've been asked if I've ever seen a psych for a range of issues, and ticked yes to anxiety, nothing about an actual official diagnosis. The insurance they offered me excluded anything mental health related. I declined the insurance and they then told me that now that they had excluded me, I now need to inform any other insurance provider that I've had exclusions! I then told them exactly where they could shove their policy.

This doesn't just apply to mental health issues either, its any medical condition.

In fact I'm pretty sure I had to sign forms to permit them to request the info from doctors. You had to give them the names of the doctors though.

I was much younger and wish I walked as soon as they handed me the forms, total invasion of privacy.

#19 Sancti-claws

Posted 25 May 2019 - 06:25 AM

View Postflowermama, on 23 May 2019 - 08:50 PM, said:

She's emotionally destroyed and her eldest child has been affected by what he's seen and heard but she's insistent that she won't be the one to break up the family (believe me, I've tried everything I can and so has her family to get her to see that he's the one breaking things up and at this point there's nothing left to be salvaged).
Can you steer her to Chumplady?  Finding out that she isn't alone and that her making decisions for the benefit of her own mental welfare and that of their child isn't breaking up a family but rebuilding?

Also, as has been said here, you don't NEED to be on a Mental Health Care plan to see someone for help - there are many psychologists and counsellors out there, finding the right fit for the right fee is the main thing.

#20 ~TSC~

Posted 25 May 2019 - 06:37 AM

Is she working? If so does she have access to an EAP?

#21 Sunshine streaming

Posted 25 May 2019 - 08:18 AM

View Postteaspoon, on 24 May 2019 - 10:03 PM, said:

No, a diagnosis isn't required. A person could be distressed about a life event and in need of psychological support. Distress isn't a diagnosis.

This is incorrect. In order to be eligible for a Mental Health Care Plan, the GP must believe that you have a mental health issue, such as depression, anxiety, ptsd, adhd, adjustment disorder. All mental health care plans include diagosis and then the psychologist confirms the diagnosis and treatment plan.

GP's may refer a client who is distressed due to non-mental health conditions, but in order to be eligible for a Medicare rebate, they must label the condition under one of the mental health conditions that are eligible for a treatment plan. This is common, particularly for GP's to label distress as Depression, Anxiety or Adjustment disorder in order to help a patient gain the rebate.

The problem is that then life insurance and income protection companies seek disclosure of the "pre-existing" condition.

Edited by Sunshine streaming, 25 May 2019 - 08:21 AM.


#22 Soontobegran

Posted 25 May 2019 - 08:52 AM

Judging by this thread I would say it is best to consult Medicare themselves.

For what it is worth I would expect my GP to disclose past mental health disorders to any specialist I may be referred to or any other GP I moved to.
If it is part of your health history it is no less important than any other medical issue.

Edited by Soontobegran, 25 May 2019 - 08:54 AM.


#23 Greatmum

Posted 25 May 2019 - 10:57 AM

U do not need to tell any employer of any mental health issues or diagnosis.

#24 QuirkyMum

Posted 25 May 2019 - 02:08 PM

View PostYodaTheWrinkledOne, on 24 May 2019 - 04:53 PM, said:


did you have the same referral doctor? They can disclose prior medical information when they write up a referral.
Nope.
Only for of the second opinions I used my regular ( same) GP.

#25 flowermama

Posted 27 May 2019 - 08:07 PM

Quick update, my friend has decided she'll talk to somebody but will do it privately. So if anyone has any recommendations for an amazing psychologist in Melbourne let me know!




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