Key points:
- Australians can access 10 subsidised psychology sessions in 2023 rather than the current 20.
- The additional 10 psychology sessions had been subsidised by the government as part of a response to the COVID-19 pandemic.
- A report recommended the additional sessions to continue to be made available.
Psychology sessions "saved" the life of Melbourne mother of three Laura Strehlau, but a plan to halve the number of subsidised appointments from next year has her "worried".
The federal government made the announcement on Monday to reduce Medicare-rebated psychology sessions from a maximum of 20 to 10 per year. This could potentially increase the cost of any additional sessions by hundreds of dollars.
The additional 10 psychology sessions had been subsidised as part of a response to increased mental health needs in society during the earlier stages of the COVID-19 pandemic.
A statement released by Health Minister Mark Butler said the Better Access Initiative, under which the additional subsidies were provided, “was not delivering for all Australians equally”.
“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,” it read.
It said it was "in light of these findings" that the additional 10 sessions would not be offered beyond 31 December.
But the scrapping of the additional access to reduced-cost sessions went against a recommendation by an independent evaluation of the initiative - conducted by the University of Melbourne - when the policy change was announced on Monday.
The report found the uptake rate of the sessions beyond the first 10 was about 15 per cent (more than one in eight people) and most of those who used them were from urban and affluent areas.
One of its recommendations was for the additional sessions to continue to be made available and be targeted towards those with complex mental health needs.
Additional sessions 'saved my life'
Ms Strehlau, who uses Twitter to advocate for those with mental illness, has condemned the move to reduce the subsidies for additional sessions.
In a video posted online, the single mother, who has bipolar disorder, said “those extra 10 sessions a year, when I was most sick, they saved my life”.
“To think that there are other people with the complex mental health illnesses he [Mr Butler] states in his press conference, to think that they will be limited to 10 sessions a year, it makes me terribly worried for those people who are acute,” she said.
“I am one of the people that couldn’t have accessed regular psychology without the additional funding.”
Laura Strehlau says access to more subsidised psychology sessions is required. Source: Supplied
As Ms Strehlau’s mental health improved, she moved to fortnightly sessions and now has one every three weeks.
She said the cost to the government would be higher if people in similar situations were not able to afford additional sessions with a psychologist.
“By me having regular psychology sessions, I will finish my uni degree, I’m able to stay stable, then I'm able to go out into the workforce and be a valuable member of our community,” Ms Strehlau said.
“I don't get acute episodes anymore because of things like psychology and medication,” she said.
“I'm not putting pressure on our mental health services ... it also means that I can participate in the community and I can be a mum,” she said.
How much does a psychologist cost?
The Medicare subsidy provides a $131.65 rebate for a 50-minute session with a clinical psychologist and an $89.65 rebate for a psychologist, with the patient out of pocket the gap amount between this and what the mental health professional charges.
While some may bulk bill, the government’s report showed about three-quarters of people were out of pocket after seeing a psychologist and the average amount they were out of pocket was between $73 and $105.
While psychologists set their own fees, the Australian Psychological Society’s recommended fee for a session is $280, so if a practitioner uses this as their fee, without a subsidy, this is how much their patient would have to pay for any sessions beyond 10.
'Detrimental impact'
Clinical psychologist and senior lecturer at Deakin University David Hallford said he believed the reduction of subsidised sessions would have a detrimental impact on mental health within the community.
“When you've got people that are left, only partially treated, and it is the case that actually many consumers will space out their sessions knowing there's only 10, or they may drop out of therapy because they feel they are not going to ‘be fixed’ then they're likely to relapse,” he said.
“If they do get successful treatment, and again, that might mean lots of sessions for some people, but less for others, then it will reduce their risk of relapse.
“You don’t say well, let’s take the bandage off before it's healed so we can let someone else get the advantage.”
He said the government needed to consider what constituted effective treatment for different groups of people, giving the example of how those with eating disorders are given access to a greater amount of subsidised sessions.
Clinical psychologist David Hallford, who is a senior lecturer at the School of Psychology at Deakin University, has questioned the reasoning behind the policy change. Source: Supplied / Simon Peter Fox Photographer
Mr Hallford questioned why then the seemingly "arbitrary" number of 10 sessions was all others were allowed.
"It needs to be thought of in terms of on a needs basis,” he said.
Mr Butler said the government would convene a forum of key experts and people with lived experience of mental illness to assess the recommendations from the initiative's evaluation and provide reform advice in early 2023.
The forum is expected to consider how to support access to higher levels of treatment for those who need it, while supporting equitable access for vulnerable and marginalised Australians.
Readers seeking support with mental health can contact Beyond Blue on 1300 22 4636. More information is available at . supports people from culturally and linguistically diverse backgrounds.
