Psychiatrists are medical specialists who diagnose and treat mental health conditions providing both therapeutic and pharmacological interventions. They use a range of therapeutic approaches to help TAC clients with the treatment of a transport accident-related injury, including conditions such as:

• anxiety
• depression
• PTSD

The TAC can pay for the reasonable cost of approved psychiatric services for clients with mental health issues as a result of their transport accident-related injury. These services must be referred by a medical practitioner. If a provider’s fee is higher than the TAC rate, the client may need to pay the difference.

Where a pre-existing condition has become aggravated as a result of a transport accident, the TAC will consider funding treatment for that condition. The level of treatment that the TAC can consider funding will depend on the extent to which the transport accident has exacerbated the pre-existing condition.

Psychiatric services provided to TAC clients are reimbursed according to the TAC's fee schedules guided by the Medicare Benefits Schedule for psychiatrists (see fee schedule). Providers can be paid directly by the TAC or clients can be reimbursed for payments made to providers.

The TAC will review the client’s treatment to ensure it is reasonable, clinically justified, outcome focused and in line with the Clinical Framework and notify the provider and client of the decision.

• psychiatric services that are reasonable, clinically justified, and outcomes focused
• travel time for psychiatrists conducting community-based treatments when clinically justified.

• services unrelated to transport accident injuries
• services that are not evidence based, reasonable, clinically justified and outcome focused
• costs exceeding the TAC rate unless pre-approved.

Within the first 90 days of a client’s accident, the TAC can help pay for psychiatric services without the need for prior approval when referred by a treating medical practitioner. The TAC may contact clients or their service providers to discuss client progress and ensure that treatment is clinically justified, and outcome focused.

If a client needs psychiatry beyond 90 days after their transport accident, the TAC will pay for a consultation with a client’s doctor, who may refer the client to a psychiatrist for services.

The TAC may request psychiatrists to provide a copy of the medical and/or progress report following treatment.

The TAC will review clients’ treatment to ensure it aligns with the Clinical Framework and continues to be reasonable, clinically justified and outcome focused. Based on this assessment, the TAC will inform the provider and client about what the TAC will help pay for and for how long.

When the TAC client has not received treatment in 6 months, they need to seek approval from the TAC before further treatment. Providers should ask the TAC client for a copy of their approval if they haven’t seen them in 6 months.

To provide TAC-funded psychiatry, a psychiatrist must:

• be registered as a psychiatrist with the Australian Health Practitioner Regulation Agency (AHPRA)
• comply with the TAC Mental Health & Wellbeing policy
• adhere to the principles of the Clinical Framework for the Delivery of Health Services

Service Standards:

The TAC expects mental health and wellbeing providers to integrate the principles of the Clinical Framework for the Delivery of Health Services (Clinical Framework) in their daily practice.

Providers are expected to:

• use person-centred care
• promote client independence
• be goal-oriented and time-limited
• engage the client’s support network
• develop and implement transition plans
• deliver services appropriately and be equipped with necessary specialised knowledge

Conflict of interest

Providers are expected to deliver services in line with the TAC’s policy on Funding Treatment by a Member of the Client's Immediate Family.

The TAC uses the following principles to aid socially and economically responsible decision-making in line with the Transport Accident Act 1986:

1. Entitled:

The TAC client is entitled to psychiatric services if:

• the TAC has accepted liability for the transport accident-related injury or condition requiring psychiatric support

2. Reasonable:

When determining if psychiatric services are reasonable, the TAC considers whether the cost of the service is reasonable in relation to the medical services reimbursement rates.

3. Clinically Justified

The TAC will decide if psychiatry is clinically justified, the TAC considers:

• if this service is appropriate to support the client to achieve their transport accident-related recovery goals
• how the client is presenting, and how will the treatment address barriers to these goals
• how will efficacy of treatment be measured, considering best practice and outcome measures
• whether the provider has taken steps to build client independence and self-management
• whether all elements of the clinical framework have been considered.

4. Outcome Focused

The TAC will decide if the psychiatric service is outcome focused. This includes the TAC considering whether the service is progressing and/or achieving the referral goals.