Is headspace making a difference to young people’s lives?

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6. The Costs of headspace (and potentially other funding streams) are not able to be observed. This would entail, for example, young people that are referred to services outside a headspace centre during an initial consultation within a headspace centre. Valuing the in-scope MBS component Using data sourced from the headspace centre Service Application (hCSA) database, we are able to observe those services that were reported as being directly funded by the MBS and the type of service provider who administered the service. From published Medicare data, we are also able to estimate an average benefit paid for services that generally attract the MBS. These data are shown in Table 6.4 below. Table 6.4 Average MBS benefit by service provider, 12-25 year olds, 2013/14 financial year Service Provider No. Services Benefits paid Average Benefits Paid Clinical Psychologists 393,358 $50,443,299 $128.24 GPs 533,740 $44,317,337 $83.03 Other allied health 536,113 $47,116,390 $87.89 Psychiatrists 327,721 $51,155,399 $156.09 Total 1,790,932 $193,032,425 $107.78 Data Source: Medicare tables Within the 2013/14 financial year, young people aged 12-25 years received 1.79 million services that were funded through the MBS. These services have a total benefit paid of just over $193 million. An average benefit paid per service for each service provider has been estimated, with a service provided by a psychiatrist receiving on average $156 in Medicare benefits, clinical psychologists $128 and GPs around $83. In order to calculate the contribution of MBS to headspace services, these averages have been applied to services observed within headspace centres that have reported being funded through the MBS. Table 6.5 Estimated MBS benefits for headspace clients, by service provider, 2013/14 financial year Service Provider Average Benefits Paid No. of headspace occasions of service Estimated MBS benefit towards headspace services Clinical Psychologists $128.24 55,851 $7,162,201 GPs $83.03 17,865 $1,483,393 Other allied health $87.89 11,332 $995,923 Psychiatrists $156.09 3,642 $568,567 Total 88,691 $10,210,085 Notes: Only those service providers that are generally eligible to receive the MBS have been included. Data within the hCSA is completed by the service provider and may be unreliable in some circumstances. Data Source: Medicare tables and hCSA For this analysis, a total of 88,691 occasions of service were deemed to be in-scope firstly because they reported attracting the MBS, and secondly because they were eligible to receive MBS benefits (Table 6.5). The majority of these services (more than half) represents those provided by clinical psychologists. These services have an estimated MBS benefit value of $7.16 million. Services provided by GPs are the second most common service that attracts the MBS within headspace centres. Almost 18,000 headspace GP services within the 2013/14 financial year received Medicare funding, with a total value of $1.48 million. Other allied health services and services provided by social workers comprise 11,332 occasions of service at an estimated value of $995,923. Lastly, 3,642 psychiatric services received MBS funding at an estimated value of $568,567. The total estimated MBS value that has gone towards a headspace client’s treatment is approximately $10.2 million. This value is added to the overall government investment towards providing services at headspace centres within the 2013/14 financial year. Social Policy Research Centre 2015 headspace Evaluation Final Report 108
6. The Costs of headspace Other government investment As discussed earlier, a number of other government funding streams are operating within headspace centres. The value of some of these funding streams is not able to be estimated with the current available data, and hence this analysis represents an under-estimate of total government investment directed at headspace services. These streams are described below. The Access to Allied Psychological Services (ATAPS) is a targeted, discretionary fund that was previously administered through the Divisions of General Practice and Medicare locals (ATAPS Operational Guidelines, 2012). Estimates gained within the hCSA data show that 5.6% of services are funded directly from ATAPS. Services funded under ATAPS tend to be provided by psychologists (48%), mental health nurses (17%) and social workers (10%). The Mental Health Nurse Incentive Program (MHNIP) provides a non-MBS payment to community based general practices, private psychiatrist services, Divisions of General Practice, Medicare Locals and Aboriginal and Torres Strait Islander Primary Health Care Services who engage mental health nurses to assist in the provision of coordinated clinical care for people with severe mental disorders. A smaller proportion of services are provided through direct funding from the MHNIP (1.8%). As expected, these services are primarily mental health nurses (77%). A small number of headspace centres, mainly Barwon, Geelong, Camperdown, Coffs Harbour and Knox are utilising this funding stream. The Rural Primary Health Services (RPHS) was established on 1 July 2008 as a response to the Audit of Health Workforce in Rural and Regional Australia. It involved the amalgamation of a number of health programs to generate efficiencies in service provision in rural and remote areas throughout Australia. The primary objective of the RPHS is to provide and maintain access to supplementary allied health and primary care services that are based on identified needs in each community. Aligning with the RPHS’s service provision guidelines, rural and regional headspace centres receive funding through the RPHS and constitute 1% of all headspace services. Launceston, Morwell, Bendigo and Warwick are more likely to be utilising the RPHS funding stream to provide services within their headspace centres. It is important to note that while these funding streams do not represent a substantial component of headspace centre operations, variation exists across each centre, with some utilising particular funding sources more heavily than others. Any changes to these programs could compromise centre operations for some centres. 6.2 Summary The estimated total value of government investment towards headspace services received at headspace centres within the 2013/14 financial year is valued at around $67.2 million (Table 6.6). The majority of this value is sourced from the headspace grant ($49.5m), which constitutes 75% of government investment into headspace services. This is followed by the MBS ($11.4m) and hNO allocation per centre ($6.3m). It is important to note that the MBS component is an estimate based upon averages within the entire Medicare system. Other government investment including that related to the Mental Health Nurse Incentive Program and the Access to Allied Psychological Services are unable to be valued at this time, but only constitute a small component of the overall government investment. Overall, it is estimated that an average occasion of service within headspace centres costs $339 per occasion of service 36 , taking into account the full government investment. An average treatment for all headspace clients (5 services per client) is estimated to attract just over $1,695 in total government investment. 36 There is no similar program with which to directly compare and benchmark headspace program costs; however, this occasion of service cost compares closely to ambulatory services which nationally averaged $303 per treatment day in the 2012-13 financial year (excluding Victoria). Ambulatory care services (a form of community based mental health services) are provided by outpatient clinics (hospital or clinic based), mobile assessment and treatment teams, day programs and other services dedicated to assessment, treatment, rehabilitation and mental health care (SCRGSP, 2015). Social Policy Research Centre 2015 headspace Evaluation Final Report 109
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Is headspace making a difference to
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Authors This report was written by
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5. Service Delivery Model 73 5.1 Wh
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Table 6.1 Table 6.2 Table 6.3 Main
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Figure 4.9 Figure 4.10 Figure 4.11
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Executive Summary headspace 1 aims
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Executive Summary or very high leve
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Executive Summary through mental he
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value to society of the improvement
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1. Introduction people in Australia
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2. Evaluation Methodology 2.1 Aims
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2. Evaluation Methodology Evaluatio
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2. Evaluation Methodology Table 2.3
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Appendix B centres and Localities i
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Appendix B for greater flexibility
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Appendix B Additional consideration
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Appendix B of achieving more effici
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Appendix B • Used the simulation
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Appendix C information relating to
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Appendix C Regarding gender, in bot
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Appendix C Table C1 Information Sum
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Appendix C Data Cleaning and Analys
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Appendix C groups. The age and sex
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Appendix C Figure C8 Demographic ch
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Appendix C The KeySurvey software s
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Appendix C different client groups.
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Appendix D Round State Centre Name
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Appendix E Characteristics HS clien
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Table E4 Cell Sizes for Figure 3.4
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Appendix F Figure F1 Changes in K10
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Appendix F three SEIFA quintiles. A
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Appendix F Occasion of service inte
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Appendix G Supplementary material f
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Appendix G Table G3 Round 3 (10 cen
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State (youth population) a headspac
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Appendix G Table G12 Round 11(16 ce
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Table G16 Additional youth populati
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Round Region State Additional youth
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Appendix G Table G25 Centres alloca
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References Atkins, D.C., Bedics, J.
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References Smith, E., Jones, T., Wa
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