Mental Health Care Under Medicare Shown To Be Essential For Community, Australia

Main Category: Mental Health
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 14 Apr 2008 - 13:00 PST

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The extent of the community need for treatment of mental health problems has been clearly demonstrated by the high uptake of the Better Access to Mental Health Care Medicare items, according to the Australian Psychological Society, accounting for the larger than expected costs.

'However, surprisingly less than half the costs associated with the initiative involve treatment items by allied health professionals, mainly psychologists,' said APS Executive Director, Prof Lyn Littlefield, 'while GP Mental Health Care Plan and Review Medicare item number costs reflect almost as much as the treatment items, with a much smaller amount going to psychiatrists.'

In March 2008 the Australian Psychological Society (APS) conducted a survey to investigate use of the items among psychologists. Over 2000 psychologists who provide Medicare funded services under the Better Access initiative responded to the survey, 649 of these being Clinical Psychologists.

'Psychologists taking part in the survey report that approximately 73% of their clients would not have been able to access psychological services without a Medicare rebate, demonstrating the huge, previously unmet need of the Australian population for access to affordable psychological treatment,' said Prof Littlefield.

'Most importantly the results show that Medicare funded psychological services are reaching a population with very significant psychological needs, with psychologists in both city and country locations reporting that 81% of clients that they have seen under the initiative presented with psychological disorders in the moderate to severe range.'

Other survey results show that:

- Services offered in regional, rural and remote locations are in accord with Medicare data indicating that 20% of clinical psychologists and 23% of registered psychologists provide services in these areas. This has led to a significant increase in psychological treatment offered in locations where there were previously few mental health services available.

- Of the Medicare funded psychological services offered in regional, rural and remote locations, both the APS survey and the newly released Medicare data indicate that approximately 50% of services in these areas are bulk billed by psychologists. Of those services that are not bulk-billed the average gap payment remains low at around $28 - $32, similar to gap payments offered by GPs for a long consultation and significantly lower than gap payments for psychiatry item numbers under this initiative.

- Psychologists reported that around 81% of clients seen under the Better Access initiative are new clients to their practice, and of these, 72% had never seen a psychologist before.

- A range of ages are represented in the client groups, with psychologists reporting that 36% of people seen under the initiative were 25 years and under, 57% were aged between 26 to 65 years, and 7% aged over 65 years.

- The most common mental health disorders treated under the initiative were anxiety and depressive disorders with psychotic disorders, drug and alcohol disorders, post-traumatic stress disorder and adjustment disorder being the next most common presentations.

- The survey results showed that the majority of clients require and complete between 5 and 12 sessions (approximately 70%). However, a substantial number of clients (14 - 17%) were found to require more than 12 sessions.

The APS is the largest professional association for psychologists in Australia, representing more than 16,000 members. The APS is committed to advancing psychology as a discipline and profession. It spreads the message that psychologists make a difference to peoples' lives, through improving psychological knowledge and community wellbeing.

Australian Psychological Society