Earlier today we launched a petition to improve access to psychological care in Australia. If you’re on this page, you probably found your way to us from there. And you might have some questions or critical perspectives that you’d like to share. Before you do that though, let’s see whether our FAQ’s below might help address what you had in mind. Scroll down to see if you find something resembling your questions. If we haven’t covered your issue, then we are happy to add your question and our response to this FAQ page (provided it is relevant and not offensive of course).
Here’s what we have so far.
But won’t this make people use too much therapy?
No. We know from decades of psychotherapy studies that even when we give people access to as much therapy as they desire, they use on average just 7 to 9 sessions. What typically occurs is that people improve until their outcome scores are in the ‘normal’ range and then they bring therapy to a close on their own (Barkham et al., 2006; Baldwin et al., 2009; Stiles et al., 2015; Owen et al., 2015). People are generally sensible and psychotherapy is not a walk in the park. Besides, we all have far better things to do with our time. We remind our politicians that the initial rationale for cutting Medicare was based on these statistical averages. The Federal Minister for Mental Health at the time (Mark Butler MP) claimed “87 per cent of people used 10 sessions or less and the average use is five.” The problem with averages is that we just can’t afford to abandon people who need more than the average amount of care. Doing so costs us more in the long-run, not just financially, but also in terms of the burden of human suffering and loss of life. If the average use of therapy is so low then we are not saving significant amounts of money by denying people treatment. On the other hand, denying care when it’s needed costs us more in the long run simply due to the fact that unresolved psychological distress tends to ruin people’s lives.
Wasn’t the system designed for mild problems?
Again no, that’s not the case. Politicians and their hand-picked experts have often claimed that the program was only intended for relatively mild cases, however this has been shown to be a political work of fiction. Critics who argue that the program should only serve people with mild-to-moderate mental health conditions fail to appreciate how the Medicare system is intended to function or how it is actually used by the wider general public. What we are proposing is a re-design of Medicare-supported psychological care to align with how the public actually uses therapy.
Won’t this cost Australia more?
Actually, it wont. All of the data shows that we save money (and lives) by investing in psychological care. First, we know that giving people access to psychotherapy reduces dependence on medications, the need for ongoing consultations with primary care physicians, length of in-patient stays at hospital, and general health care expenditures by 60% to 90% (Chiles et al., 1999; Kraft et al., 2006). In Australia, the average estimated cost for a single night in a psychiatric hospital is over $1000. More recently, research based on over 22,000 clients across a five-year period, suggests that outpatient psychotherapy helps by reducing work disability days (by 41.8%), hospitalisation days (by 27.4%), and inpatient costs (by 21.5%). The long-term effects reveal that the number of sick days was lower (by 23.8%) one year after psychotherapy (Altman et al., 2016). In terms of economic productivity, for every dollar we spend there is a $2 to $3 return on investment. And when we factor in health costs, for every dollar we spend we see 3 to 5 times the benefit in health returns (Chisholm et al., 2016). It’s hard to find any other area in health care with such returns. More to the point though, if Australia spend so much on awareness for mental health concerns, then surely it makes sense for us to grant people access to enough support to recover.
We trust that clarifies, and please, if you do have further questions or criticism of our proposed change in policy, let us know using our comment thread. If you wish to return to our petition page, simply click here.