Veterans’ Entitlements (Treatment Principles – Mental Health Disorders - Diagnostic Protocols) Amendment Instrument 2014

Administered by Department of Veterans' Affairs

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EXPLANATORY STATEMENT

 

Veterans’ Entitlements (Treatment Principles – Mental Health Disorders - Diagnostic Protocols) Amendment Instrument 2014

 

EMPOWERING PROVISIONS

 

The Veterans’ Entitlements Act 1986 (the VEA) – subsection 90(5).

 

PURPOSE

 

The attached instrument (2014 No.R113) varies provisions in the Treatment Principles under the VEA.  The Treatment Principles is a legislative instrument that sets out the circumstances in which treatment may be provided under the VEA to persons eligible for treatment (entitled persons) and the circumstances in which the Repatriation Commission (Commission) may accept financial responsibility for treatment provided to entitled persons.

 

The provisions being varied (mainly in Treatment Principle 2.4) relate to treatment for, among other conditions, mental health conditions.  Previously only the mental health condition of Post-Traumatic Stress Disorder (PTSD) was covered.  Under the variations, other mental health conditions will be covered by Treatment Principle 2.4, namely alcohol use disorder and substance use disorder.

 

Further, the variations will provide that the diagnosis of PTSD, alcohol use disorder or substance use disorder (the relevant conditions) may be made by:

 

  • a psychiatrist; or
  • a clinical psychologist; or
  • a general practitioner (as defined in subsection 3(1) of the Health Insurance Act 1973).

Previously only a psychiatrist could diagnose PTSD.

 

Under the VEA treatment of the relevant conditions is known as “non-liability health care”.  This means that a veteran diagnosed with one of the relevant conditions does not need to establish a link between the condition and service in order for DVA to pay for treatment of the condition.

 

Treatment of mental health conditions of service and ex service personnel is a high Government priority.  By enabling general practitioners and clinical psychologists to also diagnose the relevant conditions under the Treatment Principles the potential for treatment of these conditions is significantly increased.

 

CONSULTATION

 

No.  The measures are required as a matter of urgency.  Increased access to treatment is in issue.  It is noted that under paragraph 18(2)(b) of the Legislative Instruments Act 2003 an example of a situation where consultation may be inappropriate in relation to a legislative instrument is where the instrument is required as a matter of urgency.

 

In any event, the measures are beneficial and interested parties could reasonably be expected to agree to them.

 

RETROSPECTIVITY

 

None.

 

DOCUMENTS INCORPORATED-BY-REFERENCE

 

No.

 

HUMAN RIGHTS STATEMENT

 

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

The attached legislative instrument engages and promotes the Right to Health contained in article 12(1) of the International Covenant on Economic Social and Cultural Rights.

The changes made by the attached instrument are intended to advance the health of an entitled person.

Firstly, if the person suffers from PTSD, he or she will no longer need to have the condition diagnosed by a psychiatrist in order for the condition to be treated under the Treatment Principles, the diagnosis of a general practitioner or clinical psychologist will suffice. 

Secondly, if a person suffers from alcohol use disorder or substance use disorder, the person will now be eligible for treatment under the Treatment Principles without needing to establish a link between the relevant condition and service.

It is considered the attached instrument is compatible with Human Rights.

Michael Ronaldson

Minister for Veterans’ Affairs

Rule-Maker

 

FURTHER EXPLANATION OF NEW PROVISIONS

 

See: Attachment A

 


Attachment A

 

Section [1]

This section sets out the name of the instrument - Veterans’ Entitlements (Treatment Principles – Mental Health Disorders - Diagnostic Protocols) Amendment Instrument 2014.

 

Section [2]

This section provides that the instrument commences on the day after it is registered on the Federal Register of Legislative Instruments.

 

Schedule 1

 

This Schedule varies the Treatment Principles under the Veterans’ Entitlements Act 1986.

 

Item 1

This is a definitions item.

 

Item 1A

This item inserts a definition of “general practitioner”.  The term “general practitioner” has the same meaning it has in subsection 3(1) of the Health Insurance Act 1973.

 

Item 2

This item includes the new mental health conditions of alcohol use disorder and substance use disorder in the heading to Treatment Principle 2.4.

 

Item 3

This item is the same in substance as the provision it replaced except that it also includes the new mental health conditions of alcohol use disorder and substance use disorder.  This item enables the Department of Veterans’ Affairs (DVA) to pay for treatment of the new conditions, in addition to treatment of the other conditions, on and from a day 3 months before the date an application for treatment is received by DVA .

 

Item 4

This item is the same in substance as the provision it replaced except that it also includes the new mental health conditions of alcohol use disorder and substance use disorder.  The item enables DVA to pay for the treatment of a veteran with one of the relevant conditions upon the diagnosis of a psychiatrist, a clinical psychologist or a general practitioner.  Previously PTSD could only be diagnosed by a psychiatrist.

 

Item 5

This item is the same in substance as the provision it replaced except that it also includes the new mental health conditions of alcohol use disorder and substance use disorder.  The item enables DVA to require a veteran to be examined for one of the relevant conditions by a psychiatrist before it will pay for treatment of the condition.  The examination will be at DVA’s expense. 

 

This provision covers cases where DVA decides a diagnosis of one of the relevant conditions by a general practitioner or clinical psychologist is insufficient or there is some other relevant reason for seeking a diagnosis from a psychiatrist.

 

Item 6

This item is the same in substance as the provision it replaced except that it also includes the new mental health conditions of alcohol use disorder and substance use disorder.  The item enables DVA to stop paying for treatment of a relevant condition if the Repatriation Commission is satisfied the veteran being treated no longer suffers from the condition.

 

Item 7

This item is the same in substance as the provision it replaced except that it also includes the new mental health conditions of alcohol use disorder and substance use disorder.  The item enables DVA to pay for treatment of a condition, even if it is not war-caused, where treatment of the condition is a necessary part of, or directly associated with, treatment of a relevant condition.

 

Overview

The Veterans’ Entitlements (Treatment Principles – Mental Health Disorders - Diagnostic Protocols) Amendment Instrument 2014 amends the Veterans’ Entitlements Act 1986 (VEA) to enhance the treatment of mental health conditions for veterans, specifically addressing gaps in the coverage of mental health disorders beyond Post-Traumatic Stress Disorder (PTSD). This legislative instrument was enacted to improve access to treatment by expanding the types of mental health conditions covered under the VEA and broadening the qualifications of healthcare professionals who can diagnose these conditions. The policy objective of this amendment is to ensure that veterans receive timely and appropriate treatment for mental health conditions such as alcohol use disorder and substance use disorder, without the necessity of establishing a direct link to their service. By allowing clinical psychologists and general practitioners, in addition to psychiatrists, to diagnose these conditions, the legislation aims to facilitate quicker access to treatment, thereby promoting the health and well-being of veterans. The urgency of these measures reflects the government’s commitment to addressing mental health issues among service personnel as a priority.

Scope and Application

The Veterans’ Entitlements (Treatment Principles – Mental Health Disorders - Diagnostic Protocols) Amendment Instrument 2014 amends the Treatment Principles under the Veterans’ Entitlements Act 1986 to expand the range of mental health conditions that are eligible for treatment and to modify the diagnostic protocols for these conditions. This amendment applies to veterans and other eligible persons who require treatment for mental health conditions, specifically expanding the coverage to include alcohol use disorder and substance use disorder, in addition to the previously covered Post-Traumatic Stress Disorder (PTSD). These provisions are applicable nationally across Australia and are intended to ensure that treatment for these conditions is accessible and facilitated by qualified professionals. The amendments allow the diagnosis of PTSD, alcohol use disorder, or substance use disorder to be made by psychiatrists, clinical psychologists, or general practitioners, thereby broadening the scope of practitioners who can diagnose these conditions and thus increasing access to treatment. The Department of Veterans’ Affairs (DVA) may still require a psychiatrist’s examination in certain circumstances, but the initial diagnosis can now be made by a broader range of professionals. These changes are designed to expedite the treatment process and ensure that veterans receive timely and appropriate care for their mental health conditions.

Key Provisions

The Veterans’ Entitlements (Treatment Principles – Mental Health Disorders - Diagnostic Protocols) Amendment Instrument 2014 introduces significant changes to the Treatment Principles under the Veterans’ Entitlements Act 1986 (VEA). These changes mainly affect Treatment Principle 2.4, which deals with the provision of treatment for mental health conditions, including Post-Traumatic Stress Disorder (PTSD), alcohol use disorder, and substance use disorder. Under the amendments, the definition of who can diagnose these conditions has been expanded to include clinical psychologists and general practitioners, in addition to psychiatrists (section 1 and 2). This broader scope of diagnosticians aims to increase the potential for treatment of these conditions. The obligations imposed by the Act on the Department of Veterans’ Affairs (DVA) and other relevant parties include the provision of treatment for veterans diagnosed with the specified mental health conditions. DVA is obligated to pay for treatment of these conditions from a date that is three months prior to the date an application for treatment is received by DVA (section 3). Additionally, DVA can require a veteran to be examined by a psychiatrist if it deems a diagnosis by a general practitioner or clinical psychologist insufficient or if there is another relevant reason for such an examination (section 5). DVA also has the authority to cease paying for treatment if the Repatriation Commission determines that the veteran no longer suffers from the relevant condition (section 6). Furthermore, DVA is required to cover treatment of conditions that are necessary parts of, or directly associated with, the treatment of the relevant conditions, regardless of whether these conditions are war-caused (section 7). The legislation does not explicitly outline offences, penalties, or civil/criminal consequences for breach of its provisions. However, given the nature of the Act and the responsibilities it assigns to DVA and the Repatriation Commission, any failure to adhere to these obligations could potentially lead to administrative or legal repercussions. For instance, if DVA were to fail in its duty to provide timely treatment or to cease funding for treatment when required, this could result in legal actions or penalties as stipulated by other relevant legislation governing administrative processes and obligations.

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