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Is decision to cut access to mental health support short-sighted?

Health Industry Hub | December 15, 2022 |

The Australian Medical Association (AMA) welcomed the release of the final report of the Better Access evaluation, showing that it is helping to improve health outcomes for people with mental illness but that other programs are needed to complement the initiative to support hard-to-reach populations.

Despite this, Health Minister Mark Butler announced the number of Medicare-funded psychology sessions people can access will be halved to the pre-pandemic level of 10 appointments after 31 December. This was incompatible with the recommendation of the review that the 10 extra sessions should be kept but better targeted to people with more complex needs.

Minister Butler pointed to other sections of the review which found the option for extra sessions was largely taken up by people already getting subsidised treatment, meaning they aggravated already-long waitlists. Also, low-income Australians had a greater need for mental health services but were the least likely to access the subsidised sessions.

“So a whole lot of existing patients got more service, even though they didn’t necessarily have more complex needs. People trying to get into the system had barriers to getting it,” Minister Butler said.

Senator Tammy Tyrell, a member of the Jacqui Lambie Network, argued that Minister Butler was cherry-picking facts from the review, saying the extra sessions needed to be better targeted, not scrapped.

“Psychologists are telling me that this will make an already bad system worse. People will have to spread their sessions out so far they are ineffective,” she said.

Part of the problem is there isn’t a clear plan for whether or how this recommendation will be acted upon.

“The AMA supports the ongoing revision of mental health services to ensure they are reaching those who need them the most and we welcome a greater emphasis on directing resources to those patients who suffer complex or more severe mental health conditions,” AMA President, Professor Steve Robson said.

“The AMA agrees with the evaluation’s emphasis on the importance of multidisciplinary team engagement for community care led by GPs. We also recognise the need for the mental health system to be resourced to reach people in rural and remote areas, and those experiencing other barriers to accessing the care they need.”

Professor Robson said there is a need now to focus on the mental health workforce which underpins mental health care, urging the government to prioritise strategies to ensure workforce growth keeps pace with service demand, particularly in higher-needs areas with limited services.

“At the moment there are waitlists to see psychologists and psychiatrists, so this remains a barrier to mental health care, especially for children and adolescents.”

Professor Robson added that general practice remains the hub of all community mental health treatment, and complex mental health consultations should receive the appropriate rebate.

“This would allow patients to receive responsive and comprehensive care and afford GPs the time to develop treatment plans and arrange for follow up.

“The AMA maintains that general practitioners should review patients at key milestones along their mental health treatment pathway. This will reduce fragmentation of care across the system and support stronger linkages across care teams for people who are seeking mental health care.”

The AMA also welcomed a greater emphasis on directing resources to those patients who suffer complex or more severe mental health conditions.  

“We are committed to working closely with the federal government to improve access to mental health care services and ensure services are accessible and affordable,” Professor Robson said.  

The Government is yet to formally respond to any of the review’s 16 recommendations, beyond Minister Butler promising to convene an expert roundtable early in the new year to look at improving equitable access.

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