Overall, the perception of all stakeholders was that the services were being provided in compliance with the guidelines for the Better Access initiative. However, there appeared a wide variation in interpretation of the guidelines in respect to client eligibility and services that can be provided. The perception of most GPs and AHPs was that the eligibility criteria were broad enough to include most mental health conditions. Similarly, most AHPs indicated that the choice of intervention was based on the needs of the client and that most therapies would fall within the definitions of interpersonal therapy.

A number of providers (around one-third) indicated that the number of sessions available through the Better Access initiative did influence the choice and planning of interventions to try and remain within the approved number of sessions. The restricted number of sessions available was a concern of most AHPs with respect to providing services to clients with longstanding and/or more complex mental health problems.

A small number of GP, psychiatrists and psychologists raised concerns about some individuals in situational or relationship difficulties who were not eligible for services under the Better Access initiative being referred under a loose definition of anxiety or depression. A further concern of these respondents was the lack of outcome measurement and evidence base for services being provided.

The issue of who was referred was identified as the responsibility of the GP as the 'gatekeeper' to services through the Better Access initiative. While GPs and AHPs generally reported the importance of GPs maintaining the responsibility for making referrals, there was debate as to the requirement for GPs to maintain ongoing responsibility for the patient care under the GP Mental Health Treatment Plan.

The Better Access guidelines require a comprehensive diagnosis and treatment plan prior to the commencement of therapy. The majority (73 per cent) of respondents to the AHP survey reported that the information provided in the GP Mental Health Treatment Plan as good or fair and notably and 72 per cent of respondents reported that they had not received inappropriate referrals. Similarly in the consultations most AHPs reported that most GP referrals were appropriate and treatment plans were helpful. AHPs expressing concern in relation to appropriateness of GP referrals and information in the treatment plan noted that these were in respect to a minority of cases and that the quality of treatment plans was improving.

A number of psychologists and social workers and a small number of GPs argued that the Mental Health Treatment Plan could be undertaken by the AHP in instances where the AHP was assuming responsibility for the care and management of the client's mental health disorder. GPs reported, in some instances, that they were approached by an individual for a referral where they had not been involved and were not going to become involved in the ongoing management of the patient's mental health disorder. In this situation, a GP Mental Health Treatment Plan was perceived as adding little value to the treatment process.

They argued that it may be more appropriate to provide a referral to the AHP as they would refer to most other specialists.