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Mental health care
IHPA has developed a new classification for mental health, known as the Australian Mental Health Care Classification (AMHCC). The new classification will improve the clinical meaningfulness of the way that mental health care services can be classified.
On 25 February 2016, the Pricing Authority approved the AMHCC Version 1.0. The AMHCC will be implemented on a best endeavours basis from 1 July 2016 ahead of pricing from 1 July 2017.
The AMHCC Version 1.0 covers the admitted and community settings. At this stage, there is not enough data to develop the residential setting of the classification – IHPA will review the development when more robust data becomes available.
The classification has six major splitting variables. The first three variables are categorical variables, and the remaining variables are complexity variables.
AMHCC Version 1.0 structure
The classification is illustrated at Figures 1 and 2 and described below.
Figure 1: AMHCC Version 1.0 admitted setting structure
Figure 2: AMHCC Version 1.0 community setting structure
NB: These charts describe the six major splitting variables that comprise the AMHCC. They do not represent a clinical decision-making process.
Variables used within the AMHCC Version 1.0
The classification splits by setting: admitted and community.
The admitted setting includes consumers that are admitted for mental health care. The consumer may be admitted to a general ward or a designated psychiatric unit in a general hospital or a psychiatric hospital.
The community setting (also known as ambulatory) includes specialised and non-specialised mental health care services delivered to consumers who are not admitted to an inpatient facility.
Mental health phase of care
There are five phases of care: assessment only, acute, functional gain, intensive extended and consolidating gain. The classification also provides for ‘unknown phase’.
Mental health phase of care is defined as the “primary goal of care that is reflected in the consumer’s mental health treatment plan at the time of collection, for the next stage in the patient’s care”. It reflects the prospective assessment of the primary goal of care, rather than a retrospective assessment.
Mental health phase of care is a clinical decision. It is independent of both the treatment setting and the designation of the treating service, and does not reflect service unit type. Mental health phase of care is assessed at the commencement of an episode of care and reviewed where there is a significant change to the consumer’s symptoms and/or psychosocial functioning requiring a clinical review and a change to the mental health treatment plan.
There are three consumer age groups: child & adolescents (0-17 years), adults (18-64 years), and older persons (65+ years).
Mental health legal status
Only applies to admitted setting with acute phase for 18-64 years age group.
The mental health legal status (MHLS) is categorised as voluntary or involuntary.
MHLS is an indicator of whether mental health care is being provided under the state or territory mental health legislation. An involuntary patient may be detained in hospital under mental health legislation for the purpose of assessment or provision of appropriate treatment or care.
The HoNOS (Health of the Nation Outcome Scales) is a clinical outcomes measure that captures the symptoms and functioning of the consumer at key points within an episode of mental health care. It is a clinician-rated measure that consists of 12 items that assess the various aspects of consumers’ mental health.
The HoNOS complexity is based on the weighted sum of each mental health phase of care’s HoNOS scores. The weighted HoNOS scores are assessed against a threshold and classified as ‘high’ if greater than or equal to the threshold, and ‘moderate’ if less than the threshold.
The HoNOS is adapted as the Health of the Nation Outcome Scales - Children and Adolescents (HoNOSCA) for the 0-17 years age group and the Health of the Nation Outcome Scale 65+ (HoNOS 65+) for persons aged 65 years and above.
Only applies to community setting for 18-64 years age group with moderate HoNOS complexity.
The Life Skills Profile (LSP-16) is a clinical outcomes measure that assess the level of functioning for mental health consumers living in the community. It consists of 16 items that address issues faced when adapting to life in the community. Each item is rated on a four-point scale ranging from 0 to 3 with high scores indicating higher severity, resulting in an individual item scores, subscale scores and a total score.
The overall LSP-16 complexity is classified as high or moderate.
More information about the HoNOS and LSP-16 is available on the Australian Mental Health Outcomes Collection Network website.
Number of end classes
The final AMHCC version 1.0 has 91 end classes, of which 60 are completely classified and 31 are a result of unknown phase of care or HoNOS. This consists of the admitted setting with 45 total end classes, of which 29 are completely classified and 16 are a result of unknown phase of care or HoNOS. The remainder is from the community setting with a total of 46 end classes, of which 31 are completely classified and 15 are a result of unknown phase of care or HoNOS.
Activity Based Funding Mental Health Care National Best Endeavours Data Set – Overview and Technical Specifications
The Activity Based Funding Mental Health Care National Best Endeavours Data Set (ABF MHC NBEDS) defines information about consumers receiving mental health care within the ABF scope.
Additional information on the ABF MHC NBEDS can be found in the ABF MHC NBEDS Overview and Technical Specifications.
Activity Based Funding Mental Health Care NBEDS 2020-21 (Metadata Online Registry)
|Overview v1||ABF MHC NBEDS 2020-21 Overview v1||ABF MHC NBEDS 2020-21 Overview v1|
|Technical Specifications v1||ABF MHC NBEDS 2020-21 Technical Specifications v1||ABF MHC NBEDS 2020-21 Technical Specifications v1|
Activity Based Funding Mental Health Care NBEDS 2019-20 (Metadata Online Registry)
|Overview v1||ABF MHC NBEDS 2019-20 Overview v1||ABF MHC NBEDS 2019-20 Overview v1|
|Technical Specifications v1||ABF MHC NBEDS 2019-20 Technical Specifications v1||ABF MHC NBEDS 2019-20 Technical Specifications v1|
Activity Based Funding Mental Health Care NBEDS 2018-19 (Metadata Online Registry)
|Overview v1||ABF MHC NBEDS 2018-19 Overview v1||ABF MHC NBEDS 2018-19 Overview v1|
|Technical Specifications v1||ABF MHC NBEDS 2018-19 Technical Specifications v1||ABF MHC NBEDS 2018-19 Technical Specifications v1|
Activity Based Funding Mental Health Care NBEDS 2017-18 (Metadata Online Registry)
|Overview v1||ABF MHC NBEDS 2017-18 Overview v1||ABF MHC NBEDS 2017-18 Overview v1|
|Technical Specifications v1||ABF MHC NBEDS 2017-18 Technical Specifications v1||ABF MHC NBEDS 2017-18 Technical Specifications v1|
Activity based funding: Mental health care DSS 2016-17 (Metadata Online Registry)
|Overview V1.0 (2)|
|Technical Specs V1.0|
Activity based funding: Mental health care DSS 2015-16 (Metadata Online Registry)