Better Access serving some groups better than others, gaps widening
A new report reveals that the Australian Government’s Better Access initiative, which aims to broaden access to mental health care services, is not equally serving all Australians.
The independent evaluation by the University of Melbourne has concluded that Better Access has had positive outcomes for those accessing the scheme, however, it is serving some groups better than others, and these gaps are widening.
People from lower socio-economic backgrounds, those living in regional, rural and remote areas and aged care residents are missing out.
The evaluation considered the temporary COVID-19 measure to subsidise an additional 10 sessions under Better Access. In 2021, Australians used 5 sessions on average, with 83 per cent of people using 10 or fewer sessions.
While the evaluation saw benefit in those with more complex mental health needs continuing to access the additional 10 sessions, it also found that the additional sessions were not being appropriately targeted to those people.
In 2022 to date, less than half of those of low socioeconomic status were able to access treatment including the additional 10 sessions. Gap fees are at an all-time high. People are paying more for their care and when they can’t afford those fees, they go without.
Research consistently shows that COVID-19 has disproportionately impacted disadvantaged Australians, but evidence from the evaluation indicated these people, who are already doing it tough, are often unable to receive mental health support under Better Access.
Improving Better Access for all Australians
In light of these findings, the Australian Government will not be extending the temporary additional 10 sessions beyond the expiration date of 31 December 2022.
In early 2023, the Government will convene a forum of key experts and people with lived experience of mental illness to assess the recommendations of the independent evaluation and provide reform advice on how to improve Better Access, so all Australians have access to the same level of evidence-based care. The forum will consider how to support access to higher levels of treatment for those who need it while supporting equitable access for vulnerable and marginalised Australians.
The Government will strengthen the Medicare Benefits Schedule (MBS) to facilitate family and carer involvement in Better Access to treatment and fund mental health case conferencing. The independent evaluation provides compelling evidence in support of these MBS changes, and the Government will proceed to implement these in the first half of 2023.
In the October Budget, the Government provided an additional $114 million for mental health services, including $48 million to reinstate a loading to make telehealth psychiatry more affordable for people in rural and regional areas.
Patients who have a mental health treatment plan and current referral for sessions (whether for the initial 10 or an additional 10) will be able to use that referral to access up to 10 sessions in 2023, without having to go back to their GP. This aligns with current arrangements for the rollover of unused Better Access sessions across calendar years.
Minister for Health and Aged Care Mark Butler said, “The report shows Better Access is failing some Australians. Gap fees and wait times make it inaccessible and unaffordable for too many. The most disadvantaged Australians – those among us with the greatest need – have the least access to mental health services.
“The findings of the Better Access evaluation have provided us with an opportunity to address a variety of concerns so all Australians — no matter where they live or what their circumstances — can get the mental health care and support they need,” he added.
Assistant Minister for Mental Health and Suicide Prevention Emma McBride also said, “It is important that all Australians have access to quality, affordable mental health care – but the evaluation shows that often, those who need care the most are missing out.
“Our Government is determined to help improve the lives of people living with mental ill-health. To do this we must support evidence-based services that benefit everyone who needs them, not just those who can afford them or live in big cities.
“I look forward to working with the sector to improve Better Access so everyone can get the care they need when they need it,” McBride added.