Update on NSW mental health support for GPs and medication access

Information from NSW Health

• NSW public health services may be impacted by resignations of a number of public health psychiatrists in relation to a claim about their conditions of employment. Psychiatrists play a crucial role in providing specialist care to people experiencing serious mental illnesses, both in hospital and community settings.
  
• NSW mental health services are experiencing disruption in some areas but remain available and people will continue to receive care from our dedicated and highly skilled mental health staff.
  
• Our priority is the health and safety of our community. It is important for anyone experiencing mental health distress or concerns at any time to reach out for help and care.

Medication access

• Some medications for managing mental health or developmental disorders require either prescribing by psychiatrists or for psychiatrist led co-management arrangements with GPs. These medicines require approval by NSW Health prior to prescribing. For more information on these requirements, see https://www.health.nsw.gov.au/pharmaceutical/doctors/pages/application-forms.aspx
  
• To enable GPs to help provide continued care for patients who may be impacted by the expected disruption where psychiatrists are not available to participate in co-management arrangements, NSW Health will establish interim changes to approval requirements for certain medicines. These arrangements will enable GPs to seek interim approval to continue treatment for patients that was initiated in public health facilities, without requiring a co-management arrangement to be in place. 

Medication shortage

• There is currently a medication shortage of methylphenidate modified-release tablets, for the treatment of ADHD, globally. Information around the methyphenidate modified release tablet shortage is available at: https://www.tga.gov.au/about-shortage-methylphenidate-hydrochloride-modified-release-tablets
  
• NSW Health have established a temporary measure during the shortage to support patients to access their medicine. The temporary measure exempts pharmacists from the requirement to retain paper prescriptions and repeats for methylphenidate modified release tablets (Concerta® and Methylphenidate-Teva®) when dispensed. ​ It allows pharmacists to release previously dispensed prescriptions and repeats for these medicines to patients to assist them to source ongoing medication supply from another pharmacy when their usual pharmacy is unable to obtain the medicines due to the shortage. 
  
• Please let your patients know about this important change to help them access their medicines.
  
• During the shortage, please do not start any new patients on a methylphenidate extended-release formulation unless absolutely necessary. Instead consider alternative shorter duration methylphenidate formulations, i.e. immediate release tablets, or one of the 8-hour formulations).

Help continues to be available

• It is important for the community to be aware that our services remain available and people will continue to receive care from our dedicated and highly skilled mental health staff.
  
• If your patient needs a review of their current therapies please try to contact their usual practitioner.
  
• If your patient’s usual practitioner is not available, contact the GP Psychiatry Support Line on 1800 16 17 18.
  
• The GP Psychiatry Support Line is a free service available from 7am to 7pm (AEST) Monday to Friday, for clinical diagnostic and medication related questions. For more information: www.gpsupport.org.au
  
• You can continue to refer to the Mental Health line on 1800 011 511 for advice and connection to specialist mental health services.

Information for health practitioners is also available at News and notices.