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    “The report also says that increased access to psychological services under the Better Access and other initiatives have not addressed inequities, and that there are also unanswered questions about the effectiveness of services”. I’m a psychologist. Get the satellites up over remote communities, and optic fibre to my office, and I reckon I could provide a service to people in remote communities via Skype or YM. But you need to be able to see facial expressions and body language in REAL TIME. Current speeds don’t cut it. On whether it’s cost effective or not, someone clever needs to estimate how many people have been prevented from committing suicide by psychologists under the Better Access program. Dead people don’t pay taxes. Nor do people who don’t work because they’re stuck at home with agoraphobia. Note that the number of sessions with a psychologist under this scheme is being cut from 16 to 10.

  2. 2


    There is no real mention in the report of the necessity of getting a timely and speedy diagnosis. From the carer’s point of view this is critical. Carers cannot manage these people in the home without easily available assistance.

    At the moment, the only way you can get an acutely psychotic and non-compliant person to a hospital for treatment is to enlist the assistance of the police – a traumatic experience for both the patient and the family. Extended hospitalisation can be usually avoided if a patient can receive speedy and appropriate treatment right at the onset of symptoms, preferably on an outpatient basis or similar (via the GP supported by visiting nurses perhaps?).

    And like it or not, for patients with any sort of psychosis, the initial treatment is going to be stabilising medication.

  3. 3

    Ben Mullings

    The reference to Better Access in the above article is one-sided. The National Report Card on mental health identifies three main issues around Medicare-supported psychological treatment.

    First, the report card identifies that access to psychological treatment has increased as a result of allowing people to access services via Medicare. This is a huge step forward and shows that this approach has the potential to help an enormous amount of Australians who are trying to recover from common, but otherwise debilitating, mental health conditions.

    Second, the report card notes that the increased access has not occurred at the same rate in all locations. It points out on page 43 that this largely due to differing levels of access to a GP (the point of referral) from region to region:

    “The further you live from a major city or inner regional area your access to a GP declines and you are less likely to have a GP mental health treatment plan”

    As the evaluation of the Better Access initiative points out however, the highest rate of growth in the uptake of services has been amongst the most disadvantaged groups. Research comparing Medicare-supported services with ATAPS has shown that the Better Access initiative strongly improved access to treatment for all groups in society. So the question is how to help connect people with psychological treatment in those harder to reach sectors.

    The third point made in the report card about this issue is focused on making sure that investments are evidence-based. We do need more evidence about the effectiveness of the Better Access initiative, but what we know from decades of controlled studies is that ten sessions of psychological treatment are not enough. It is hard to see how scaling back Medicare support for people who have mental health conditions is going to improve psychological treatment outcomes.

    Our politicians need to think very carefully about this issue before they go ahead with the cuts they are planning by January 2013. A lot of people wont be celebrating a ‘happy’ new year when they realise that they can no longer afford to get help.

  4. 4

    Ben Mullings

    For those who are interested, here is the hyperlink to that research I mentioned above, comparing the Better Access initiative to its predecessor in the ATAPS program:

  5. 5

    Alice R

    I think it is great there is a report card for Mental Health but it is useless if no action is taken to help those who need it. Politicians need to hear the people of Australia who are deeply affected by the cuts to Medicare subsidised therapy.
    I’ve started with Better Access Medicare-subsidised therapy sessions this year, knowing it is limited next year to 10 sessions, below the standard recommended sessions for moderate conditions make me feel hopeless.
    I come from CALD as most like to called it, so Better Access does reach sector society that don’t usually access mental health care.
    Better Access allows people to access their treatment of choice rather than pushed onto pills because they can’t afford anything else.


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