Many people will undoubtedly be closely watching the federal government’s degree of commitment to mental health when Treasurer Jim Chalmers explained his second budget on May 9.
The demand for psychologists, psychiatrists, and mental health nurses’ services is still higher than what the system can comfortably handle after the epidemic. Many Australians are probably not receiving the treatment they have grown accustomed to as a right. The budget may or may not effectively address the issue, although health minister Mark Butler has stated that he intends to make the system more egalitarian. However, information regarding the next steps has yet to be provided.
As we have previously noted, it is concerning that an increasing number of Australians are finding the cost of receiving mental health care to be a barrier, as well as that support of any kind, particularly psychiatric support, can be challenging to locate in the first place. This is especially true for those residing in remote communities or even major regional centres, where waiting lists for consultations for non-critical conditions can be months long.
For those in crisis, on-call services from organizations like Beyond Blue and Lifeline offer a crucial safety net. Still, long-term management of mental health can frequently necessitate years of expert medical intervention.
Those Australians who need many more sessions with a psychologist than the ten that are currently part-funded by the government, delivered after consultation with a GP under a mental health plan, are particularly at risk, according to federal health reporter Natassia Chrysanthos’ article this week. The Productivity Commission referred to this group as the “missing middle” in its report on the industry in 2020.
The Morrison government increased the number of Medicare-funded sessions from 10 to 20 during the pandemic due to an increase in anxiety disorders brought on by lockdowns. Still, despite intense lobbying from peak groups, the amount was controversially reduced down to the original allotment in January.
Asserting that the epidemic was still present as a mental health burden, mental health specialists like Matt Berriman, chair of Mental Health Australia, warned the decision would affect many vulnerable individuals who would not be able to afford care. To support her conclusion, Butler used a study by Melbourne University academics that determined the program had unjustly favoured wealthy Australians and had not considerably increased widespread access to mental health treatments.
There is significance to this. Medicare spends nearly 40% more per person on the mental health of people who reside in wealthy areas compared to persons who live in low-income areas, according to a 2020 study by the Grattan Institute.
Midway through 2022, the Australian Psychological Society discovered that, as opposed to 1 in 100 before the pandemic, a third of psychologists could not accept new patients “due to overwhelming demand”. Later, it stated in a pre-budget submission that there was “a critical shortage” of psychologists, with only 35% of the nation’s demand for mental health services being met by the current workforce.
This situation is not brand-new. A parliamentary investigation back in 2006 found that access to doctors, in general, was “minimal” and that private psychiatrists were “largely inaccessible” because so few of them were bulk-billed. While this was happening, most public psychiatrists did not have time “to deal with the high prevalence disorders such as anxiety, depression, personality disorders, and drug abuse, in general treating the individually very demanding schizo-affective range of disorders.”
When speaking to peers at psychiatry meetings, it is common knowledge that everyone is booked up, an AMA-representing psychiatrist told the Senate Select Committee on Mental Health. How are you going to see patients? You can’t… You cannot keep taking on more patients and working late.
The Morrison initiative was a stop-gap measure implemented in a time of crisis that did not improve overall delivery of mental health care, even though The Age continues to call on the government to reconsider its decision to end access to the additional sessions for reasons that are obvious given the ongoing psychological and economic burden of the pandemic.
According to the research, higher demand may have caused longer wait times and the closure of some practitioners’ books to new clients, exposing underlying structural problems that must now be resolved.
What other options exist? Many suggestions include raising the overall rebate to reduce out-of-pocket costs and providing a Medicare rebate to those seeing provisional or not yet qualified psychologists. The fundamental problem, however, continues to be that there need to be more qualified practitioners for too many potential patients, necessitating, as many are asking, an improved pipeline for training.
The Albanese government’s difficulty is that its total debt has just reached a record high of $911.8 billion. But we should all anticipate seeing progress when the May budget is released. It would be a terrible failure if we were unable to continue providing the necessary support given the steps we have taken as a nation in recent years to emphasize the significance of mental health, to lessen the stigma surrounding seeking care, and to encourage discussion of common conditions like anxiety and depression.
