Mental Health News

Psychologists Concerned Over Subsidy Cuts

Psychologists concerned over subsidy cuts

Updated Mon 26 Nov 2012, 10:27am AEDT

Psychologists are concerned that the Federal Government's proposal to reduce the number of Medicare-subsidized therapy sessions will mean less people accessing behavioral health care.

From January next year, the number of subsidized sessions that can be claimed by a patient under the Better Access program, will drop from 16 to 10.

Suzanne Midford, a clinical psychologist in Perth, who has been practicing for 25 years, says 10 therapy sessions are inadequate for the majority of people seeking treatment.

"Reducing it to 10 creates a terrible problem as there are many conditions, including the most obvious ones of depression, anxiety and obsessive-compulsive-disorder, that require a greater number of sessions to assist people to be able to reach a point where they're able to start feeling better," she said.

"It's now being brought down to something which goes against all the research, which is showing that 20 sessions is needed for most mild to moderate conditions let alone severe conditions," she said.

"If you've got someone with a chronic problem, who may need to be seen over a long period of time, you can't do any individual therapy on a weekly basis because you'll run out of sessions very quickly."

In 2011, as part of a $2.2 billion mental health reform package, the Federal Government proposed to cut the yearly number of therapy sessions available under Medicare from 18 to 10.

But, in March this year they allowed for a further six appointments for those who could prove severe need based on 'exceptional circumstance'.

Now the Government is looking to remove the additional six and cap the annual number of Medicare funded therapy sessions at 10.

The Federal Minister for Mental Health Mark Butler maintains significant additional capacity has been built into the behavioral health system to counteract the increased demand for services.

He says the Government has invested $205.9 million in the Access to Allied Psychologists Services, allowing more than 180,000 people to access behavioral health workers.

Mr Butler says the Better Access program was never intended to provide ongoing services for those with severe and persistent mental illness and people are able to access other specialized mental services or up to 50 Medicare subsidized sessions with a psychiatrist.

Failed to compensate

Perth-based Dr Ben Mullings is the Chair of the Association for Counselling Psychologists and spokesman for Alliance for Better Access; both groups are opposed to the Government's cuts.

Dr Mullings believes the Government has failed to follow through on its promise to provide alternative services to compensate for the reduction of sessions.

"They're all these big budget announcements about other services which would be put in place; unfortunately practically none of them deliver on psychological treatment for the adult population," he said.

"It really is a betray of trust in many ways for people to be told they're going to receive help, that it's okay for them to trust that when they reach out for support they're going to get it, for them to diskover that it's such a difficult time, such a run around for them to get help."

Dr Mullings says the proposed cuts are even more disturbing after a recent in-depth review of the State's behavioral health services, which identified an under-resourced and over-stressed system.

"It highlighted the need for preventative care from the community and also for there to be referral options for when people are diskharged from psychiatric hospital," he said.

"Medicare is one obvious system for that, so by cutting the amount of psychological treatment people can receive via Medicare, what they're actually doing is cutting those options for those who are diskharged."

Mrs Midford says the cutbacks will pose ethical issues for psychologists, who may rethink whether to even commence therapy.

"You really have to think ethically about whether its appropriate to commence seeing people for so few sessions, because you can actually do harm if you start seeing someone and aren't able to finish it," she said.

Dr Mullings says they saw a reduction in the number of people accessing services after the initial drop from 18 to 16 subsidized sessions

"Consequently, we've seen a sharp drop off in the services that are being used," he said.

Family Physicians reluctant

"We've seen Family Physicians being reluctant, in some instances, to actually refer people to the program, we've seen people reluctant to actually start therapy knowing they've got reduced support and they've actually made it slightly harder for people to access those additional sessions."

Psychologist Suzanne Midford says those who can't afford private health insurance or to pay full price for treatment, will have to turn to the public mental health sector, where patients can wait for up to six months for an appointment.

"The system has gradually come to depend upon the private system supporting the public system through Medicare and now in effect it's going to be severely compromised by the shorter number of sessions," she said.

"The problem is people are not able to get services and that's when people start to turn to other methods, drinking or self-medication, which may cause other problems.

"There are consequences to this if we don't help people."

Mrs Midford believes the Government needs to rethink its approach to mental health care to acknowledge the real needs of the population.

"Everyone experiences behavioral health issues at times in their life, it's not something to be ashamed of, it's not something to hide, it's something for us all to recognize that we do experience these stresses," she said.

"And if we have prompt and quality intervention, we end up with a better outcome for all." 


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