Dear Minister

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Congratulations Mark Butler MP, for launching the Clinical Practice Guidelines on Management of Borderline Personality Disorder. You can find them right here.

There are some excellent points made in this well-researched document. In particular, page 56 of those Guidelines describe the characteristics of effective psychological treatments for BPD. It quite rightly points out that therapy appointments should occur regularly, with “at least one session per week” being necessary. The Guidelines go on to say:

For the psychological approaches shown to be effective in randomised clinical trials, the duration of treatment ranged from 13 weeks to several years. In clinical practice, some therapies are usually continued for substantially longer periods.

But with respect Minister, at the beginning of the year you reduced Medicare-support for psychological treatment to 10 sessions with no exceptions. So now I’m wondering, how do these new Guidelines fit with your 10 session Medicare limit?

Since August 2011, mental health care researchers and practitioners have been trying to raise with you the problems of limiting access to Medicare support below internationally recognised standards that are based on research. In a country like Australia, why can’t we base Medicare policy on basic minimum treatment guidelines recommended by research across the world?

Over 3,500 members of the Australian public have also made it clear that they want you to change the Medicare system to allow for 15-20 sessions of psychological care per year for those who need this amount of support. Even if you read just a few pages of the 200 or so that were required to contain their words, we think you might understand the need for BETTER access via Medicare, not worse.

Personally, I would like to know why you wont talk with us about this issue? As a senior elected representative with the portfolio of mental health, shouldn’t it be your responsibility to learn and understand the serious concerns of the public about our current policies which effectively stop people from getting treatment?

Please take a moment to consider our points.

Kind Regards,

Dr Ben Mullings

For those who are unfamiliar with the Medicare situation, please watch our short clip below which explains.

NOTE: Visitors to this site might also recall that the Minister did the same thing with the guidelines on the treatment of complex trauma. We wrote about that just a few months ago in October 2012. The following month, the President of the group Adult Survivors of Childhood Abuse (ASCA) who wrote those guidelines criticised the Minister’s decision to limit Medicare appointments to 10 sessions in an open letter, calling on Mark Butler MP to urgently revise the planned cuts. The Minister did not take that advice and has repeated the same mistake by endorsing the guidelines for BPD mentioned above, when his policy decisions clearly demonstrate that access to treatment is being scaled back rather than improved.