Medi­care for men­tal health dis­places coun­sel­lors

The Weekend Australian - Travel - - Health - Clara Pi­rani Med­i­cal re­porter

COUN­SEL­LORS through­out Aus­tralia have ex­pe­ri­enced a sig­nif­i­cant de­cline in de­mand for ser­vices since the Gov­ern­ment in­tro­duced fund­ing for GPs to re­fer pa­tients to psy­chol­o­gists. The Aus­tralian Coun­selling As­so­ci­a­tion (ACA) says the trend in­di­cates many peo­ple who could be treated by coun­sel­lors are be­ing un­nec­es­sar­ily re­ferred to more ex­pen­sive spe­cial­ists.

An ACA sur­vey of more than 700 coun­sel­lors found more than 90 per cent have re­ported a drop in busi­ness since the Gov­ern­ment in­tro­duced its Bet­ter Ac­cess to Men­tal Health scheme last Novem­ber.

Coun­sel­lors have no­ticed a sig­nif­i­cant drop — in some cases 30 to 40 per cent — in de­mand for ser­vices,’’ says ACA pres­i­dent Philip Arm­strong.

The Bet­ter Ac­cess to Men­tal Health scheme was in­tro­duced in Novem­ber last year, mak­ing it eas­ier for peo­ple with men­tal health disor­ders to claim a Medi­care re­bate for treat­ment by a psy­chol­o­gist.

The scheme’s pop­u­lar­ity has far ex­ceeded the Gov­ern­ment’s ex­pec­ta­tions. Be­tween Novem­ber and May 31 this year Medi­care spent $95 mil­lion on the scheme — well in ex­cess of the $34 mil­lion al­lo­cated by Gov­ern­ment to cover costs un­til June 30. Only $68 mil­lion was orig­i­nally al­lo­cated for the pro­gram for the 2007-08 fi­nan­cial year.

GPs pro­vided 48,000 con­sul­ta­tions un­der the scheme in May and clin­i­cal psy­chol­o­gists pro­vided more than 42,000, at a cost to Medi­care of $110 each. Lesser-trained psy­chol­o­gists, who get a $75 re­bate, con­ducted over 84,000 con­sul­ta­tions.

Arm­strong says many of the could be helped by a coun­sel­lor.

‘‘ Psy­chol­o­gists work with sig­nif­i­cant men­tal health is­sues such as bipo­lar dis­or­der and schizophre­nia, whereas coun­sel­lors can work with peo­ple suf­fer­ing mi­nor de­pres­sion, anx­i­ety and re­la­tion­ship prob­lems,’’ he said.

‘‘ If a pa­tient goes to his GP with a mi­nor case of de­pres­sion or anx­i­ety, the GP then writes up a care plan and part of the care plan would be a re­fer­ral to a coun­selling ser­vice and the only choice that they have is a psy­chol­o­gist — which is over-ser­vic­ing.’’

Arm­strong wants the re­bate ex­tended to reg­is­tered coun­sel­lors, claim­ing that long wait­ing lists to see some psy­chol­o­gists place peo­ple who need im­me­di­ate help at risk.

‘‘ Coun­sel­lors work in the pre­ven­ta­tive area with peo­ple who are start­ing to de­velop prob­lems so that it doesn’t de­velop into a chronic dis­ease.

‘‘ But the prob­lem is that wait­ing lists for psy­chol­o­gists are so long. We’ve had a re­port from the Hunter that peo­ple are Con­tin­ued inside — Page 19

pa­tients

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