The "Missing Middle"
Rural Psychiatry helps you manage the "missing middle"—those patients who are suffering significantly and require specialist input, but do not meet the high acuity thresholds for public mental health services.
We focus on providing Medicare Item 291 assessments to support your ongoing management.
What is Item 291?
This is a one-off "Opinion and Report" service where the psychiatrist conducts a detailed assessment and provides you with a comprehensive 12-month management plan to implement locally.
This model allows us to keep wait times low and costs zero for the patient. To ensure Medicare compliance, your referral must explicitly request "Item 291".
Clinical Scope
Mood Disorders
Anxiety & Trauma
Psychosis
Geriatric Psychiatry
ADHD (Review Only)
Note: We do not conduct initial diagnostic assessments for ADHD or Autism.
How to refer
Prepare Referral
Include current summary and medication list.
Must request "Item 291 assessment"
About Dr Matt Brazel
Dr Matt Brazel is an old age and adult psychiatrist with a specific interest in rural mental health.
He trained in Tasmania, Queensland, and the ACT, and is currently working in the public system across multiple sites in rural and regional NSW. He established Rural Psychiatry to offer a reliable, bulk-billed assessment pathway for rural patients who otherwise face long travel or wait times.
Dr Matt Brazel (MBBS, FRANZCP, Cert Old Age Psych)
