Federal Health Minister Mark Butler is facing a revolt from mental health experts, who want his government to reinstate "lifesaving" cheaper psychology sessions.
Key points:
- Health workers warn psychology clients are skipping sessions or considering stopping care following government cuts
- The federal government last month halved the number of cheaper psychology sessions available to people
- Health professionals are warning the cuts will lead to more people needing acute care
Several groups representing psychologists, emergency service workers and allied health professionals have penned a letter to Mark Butler calling on him to restore additional mental health support, or risk patients spilling over from psychology practices into already over-burdened emergency departments.
In 2020, at the height of the COVID-19 pandemic, the Morrison government announced a $100 million commitment to double the number of Medicare-subsidised mental health sessions available to patients each year, from 10 to 20.
Late last year, the new Labor government announced the so-called "Better Access Initiative" would revert to 10 subsidised sessions, arguing an independent report by the University of Melbourne found the program was not serving all Australians equally, and that those from lower-socio economic backgrounds and regional areas were missing out.
However, the report also stated that on balance, "the evidence from the evaluation suggests that the additional 10 sessions should continue to be made available and should be targeted towards those with more complex mental health needs."
Letter warns cuts puts patients at risk of harm
In a letter to the minister, the groups — including the Australian Psychological Society, Rural Health Alliance, Victorian Ambulance Union and the Australian Federal Police Association — argue the decision puts "patients at risk of harm or preventable loss of life" and "threatens the safety of emergency services personnel and health care workers dealing with an increase of mental health admissions."
"The government's decision to halve this program will reduce the quantity and quality of mental health care available to tens of thousands of Australians and create a significant risk of under-treated or no-longer-treated patients spilling over from psychology practices and into already stretched GP clinics and emergency departments," the letter states.
Australian Psychological Society (APS) president Catriona Davis-McCabe said it was vital the program was reinstated.
"Cutting this service to all really is a dangerous experiment, and particularly when it's being replaced with nothing," she said.
"We're only a few weeks into this new year and our patients and our psychologists are already telling us that they don't know what they're going to do.
"They're rationing their care. And they're also talking about stopping treatment altogether."
Minister defends decision, calls scheme inequitable
Since their inception, the additional Medicare-subsidised psychological sessions have been controversial, criticised for being tailored to those who could afford the co-payments or who lived in areas where psychologists were available.
There have been consistent calls for more money targeted at what is often called the "missing middle": people often too unwell to be treated by a primary health practitioner like a GP, but not deemed sick enough to be admitted into a mental health unit.
Mr Butler cited the "missing middle" this week as he defended the decision to cut the additional mental health sessions, arguing the system was not designed for people with more complex needs.
"People in areas with the most significant need — the highest level of mental distress — receive far fewer services than other areas in the community," he said on Monday.
"The level of access, particularly the level of equity, was made worse by the additional 10 sessions.
"I'm very clear that people who were able to get access to those 10 additional sessions appreciated them and got a benefit from them. The problem though, is it cut out a whole lot of people from getting any support whatsoever."
However, Dr Davis-McCabe said slashing subsidised psychology sessions was not going to help those already missing out on support.
"We acknowledge that Better Access needs to be improved in some areas, particularly when we're talking about the missing middle," she said.
"But the answer to that is not cutting the services to everyone.
"What we need to do is address the psychology workforce. And without addressing the core issues of workforce, we'll continue with the service gaps to people in lower socio-economic [groups] and rural and remote areas, and this is absolutely unacceptable, because your postcode should never determine your mental health."
On Monday, the health minister will hold a roundtable with mental health experts to assess the recommendations of the University of Melbourne report and look at equitable access for vulnerable and marginalised Australians.