The Guardian
Psychologists are renewing calls for the federal government to double the number of subsidised psychology sessions a patient can access, along with reducing the growing gap fee, as the cost-of-living crisis puts households under financial strain.
The Australian Association of Psychologists Inc, one of two psychology peak bodies, wants the federal government to lift the Medicare rebate by more than $50 for some sessions and increase the number of subsidised sessions from 10 to 20.
The renewed calls coincide with alarming statistics on suicide and self-harm released by the Australian Institute of Health and Welfare last week, showing higher figures in 2022 across New South Wales, Queensland and Victoria.
With a GP-approved mental health care plan, patients can receive a Medicare rebate of $93 a session with a general psychologist.
The rebate increases to $137 a session with a clinical psychologist – a psychologist with further training to specialise in a particular area.
Many psychologists are charging about $300 a session, according to the Australian Psychology Society’s schedule of recommended fees, and Carly Dober, a director at the AAPi and psychologist, said the rebate should be lifted to at least $150 for both types of psychologists.
“Research tells us, overall, Australians are feeling more mental health distress than they were last year, and in the years before that,” Dober said.
“The cost of living has made more people financially stressed or strained and has made them … make difficult decisions about where their money goes with no real end in sight,” she said.
“Unfortunately, that means that people are either rationing their treatment … or it means that people are foregoing their sessions in general because they actually can’t afford it.”
The Australian Psychology Society chief executive, Dr Zena Burgess, said the 10 sessions should stay in place for those with mild mental health conditions while 20 sessions should be offered to those with “more complex issues”.
“While the government has made some positive steps, much more is needed to ensure Australians, especially those with complex needs and our most disadvantaged, can rely on their Medicare card and not their credit card to treat their mental ill-health,” she said.
“In addition to increasing rebates for patients, the federal government should work with the states to get more psychologists working and living in areas of need, as well as investing in more psychologists in schools so we can better support our youngest Australians.”
While the federal government has conceded “more work is needed” to ensure Australians can get the mental healthcare they need, it said the temporary addition of 10 extra therapy sessions actually worsened outcomes.
Under the former Coalition government, Australians with a GP-approved mental health care plan could access up to 20 subsidised psychology sessions – a Covid-era measure that expired in December 2022 and was not renewed by the Albanese government.
The Better Access report, released in December 2022, showed the amount of new people accessing psychology sessions had reduced by 7.25% between 2020 and 2021, and out of pocket costs increased from $74 a session in 2021 to $90 in 2022.
It found while the extra 10 sessions led to better outcomes, it “disproportionately” favoured people on relatively higher incomes in major cities. However, the review recommended the extra 10 sessions remain and targeted towards those with “complex mental health needs”.
The health minister, Mark Butler, said the Coalition’s doubling of sessions had resulted in more people missing out.
Since returning to 10 sessions a year in 2023, an extra 45,000 people had accessed the Better Access program, he said.
“The temporary addition of 10 Medicare-subsidised sessions introduced during Covid worsened these problems and meant tens of thousands of Australians missed out on getting any care, altogether,” Butler said.
“An additional 45,000 people have received Better Access sessions in 2023 compared to the same period in 2022, since the former government’s scheduled end date of 31 December 2022.
“While this is a positive step, more work is needed so all Australians – no matter where they live or what their circumstances – can get the mental healthcare they need.”
A mental health reform advisory committee set up to evaluate the Better Access program is considering how to make services more accessible and affordable, and the best way to provide services for those with lower levels of needs, through to severe and complex needs.
Data released by the Australian Institute of Health and Welfare showed the number of suicides had increased in 2023 to November in Victoria. In NSW, the figure from January to October 2023 was slightly lower compared with the previous year.