Bassilios Bridget, Nicholas Angela, Reifels Lennart, King Kylie, Fletcher Justine, Machlin Anna, Ftanou Maria, Blashki Grant, Burgess Philip, Pirkis Jane
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, 3010 Australia ; School of Public Health, The University of Queensland, Herston, QLD 4006 Australia.
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, 3010 Australia.
Int J Ment Health Syst. 2016 Sep 26;10:61. doi: 10.1186/s13033-016-0092-4. eCollection 2016.
Introduced in July 2001, Australian Access to Allied Psychological Services (ATAPS) was the inaugural national policy initiative to provide community access to government-funded psychological services in primary care. Our aim was to examine the achievements of ATAPS in relation to its stated objectives using a set of indicators that largely drew on data from a minimum data set that we designed for the evaluation of ATAPS.
We used de-identified professional-, consumer- and session-level data from the minimum dataset, and secondary analyses of our quantitative and qualitative data collected for a series of specific evaluation studies. Available data covered the period from 1 July 2003 to 31 December 2012.
Approximately 350,000 referrals were made to the ATAPS program over the 9.5 year analysis period, 79 % of which resulted in services. Over 1.4 million sessions were offered. Overall, 29 % of consumers were male, 4 % children, and 3 % Aboriginal people; 54 % of consumers had depression and 41 % an anxiety disorder; at least 60 % were on low incomes; and around 50 % resided outside of major cities. The most common interventions delivered were cognitive and behavioural therapies. Selected outcome measures indicated improvement in mental health symptoms.
Access to Allied Psychological Services achieved its objectives within a decade of operation. The program delivered evidence-based services to a substantial number of consumers who were disadvantaged and historically would not have accessed services. Importantly, where data were available, there were indications that ATAPS achieved positive clinical outcomes for consumers. This suggests that ATAPS carved an important niche by successfully addressing unmet need of hard-to-reach consumers and through means that were not available via other programs. It will be interesting to see the effects from July 2016 of the reform of ATAPS, which will see ATAPS subsumed under psychological services commissioned by regional primary care organisations.
澳大利亚辅助心理服务获取计划（ATAPS）于2001年7月推出，是一项开创性的国家政策倡议，旨在让社区能够在初级医疗保健中获取政府资助的心理服务。我们的目标是使用一组主要从我们为评估ATAPS设计的最小数据集的数据中提取的指标，来审视ATAPS相对于其既定目标所取得的成就。
我们使用了最小数据集中经过去识别处理的专业、消费者和诊疗级别数据，以及为一系列特定评估研究收集的定量和定性数据的二次分析。可用数据涵盖了2003年7月1日至2012年12月31日期间。
在9.5年的分析期内，约有35万份转诊申请提交至ATAPS计划，其中79%获得了服务。提供了超过140万次诊疗。总体而言，29%的消费者为男性，4%为儿童，3%为原住民；54%的消费者患有抑郁症，41%患有焦虑症；至少60%的消费者收入较低；约50%居住在大城市以外。提供的最常见干预措施是认知和行为疗法。选定的结果指标表明心理健康症状有所改善。
辅助心理服务获取计划在运营十年内实现了其目标。该计划为大量处于不利地位且以往无法获得服务的消费者提供了循证服务。重要的是，在有数据可用的情况下，有迹象表明ATAPS为消费者取得了积极的临床效果。这表明ATAPS通过成功满足难以接触到的消费者未得到满足的需求，并通过其他计划无法提供的方式，开辟了一个重要的细分领域。看看2016年7月ATAPS改革的效果将会很有意思，改革后ATAPS将并入由地区初级医疗保健组织委托提供的心理服务中。
