Clinical characteristics of people referred for Medicare Item 291 Psychiatric Assessments in northern metropolitan Adelaide

ObjectiveThe northern suburbs of Adelaide, South Australia, are characterised by marked socio-economic disadvantage. Through private practice agreements, psychiatrists employed by this region's public health service accept referrals from General Practitioners (GPs) to undertake Medicare-Benefits-Scheme Item 291 Psychiatric Assessments (MBS-291s). This study reports the clinical characteristics of people in this region who received an assessment under this initiative.MethodData was collected from 169 consumers aged 18-65 years, who attended MBS-291s with one psychiatrist between 2017 and 2021. Data included demographics, diagnoses, comorbidities, management challenges, engagement with other services, and the psychiatrist's recommendations.ResultsOf 169 consumers, 32% were aged 18-25. Mood (37%) and trauma-related (36%) disorders predominated. Psychiatric comorbidity was common (37% had ≥2 diagnoses). Adverse experiences were reported by 92%, including psychological abuse (60%) and suicidality (51%). Medication recommendations were provided in 99% of cases, alongside psychotherapy (75%), referrals to other services (88%), and lifestyle recommendations (70%).ConclusionsThis study highlights the complex clinical and psychosocial characteristics of those referred for MBS-291s in the northern suburbs of Adelaide, South Australia. We discuss the range of specialist recommendations and comment on the value and sustainability of providing these assessments in the Australian healthcare context.