Accessing enough help

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Archived from Australian Mental Health Party

Our party wants policy to be based on good evidence. In mental health care, the government lags behind in a few critical areas. One of those is areas is Australia’s reliance on programs where people can access a fixed upper limit of appointments. That’s fine if you don’t need more than the upper limit, but what about those who do need more care? Unfortunately in programs like Medicare, those people just get cut off from therapy abruptly. If they can’t afford to cover the cost, they are on their own.

Recently two important new studies were published, showing why Australia needs a better system.

The first of these studies relates directly to the number of appointments people need (you can read it here). The results of this study are drawn from a large sample (N=925) and challenge the notion of having a fixed number of sessions or duration of care. The authors recommend a more flexible approach to care, explaining that their findings “support the implementation of individualized intervention lengths, which appear to result in shorter interventions for those patients who respond quickly to therapy and longer interventions for those who respond more slowly.”

The second study was also very large, a review of other studies, called a meta-analysis. It explored whether a person’s preferences for the type of treatment they receive makes a difference (you can find that study here). Across 53 studies and over 16,000 clients, the researchers found that accommodating client preferences for choice of therapist or type of treatment significantly improved outcomes and reduced the rate of early drop out. Those whose preferences were not matched or who were not given a choice of their treatment conditions were nearly twice as likely to withdraw from seeking care prematurely. The effect size of therapy preferences on positive treatment outcomes was small but significant and positive (d = 0.28).

For most of you, the results of these studies won’t seem like rocket science. Surely it makes sense to let people decide who they want to see, what form of treatment they get, and allow them to access enough psychological care to bring therapy to a close when they are ready. You may be surprised how hard it has been to convince our political leaders of the need to get this part of the system right.

There’s a careful balancing act at stake here. On the one hand, Australia doesn’t want to pay for more therapy than we actually need. On the other hand, we don’t want to cut people off too early. In both cases, the cost weighs a heavy burden both personally and collectively. We must remember that systems like Medicare are intended to keep people as healthy, functional, and as productive as possible, so we can all contribute to our society. In a system like Medicare, it makes sense to allow people the flexibility to access more care than they might need, because it doesn’t cost the taxpayer any additional expense beyond the actual cost of services people use. That is, once a person stops accessing therapy there is no further cost.

In previous years, I’ve tried educating our politicians about this issue with dot point summaries of the evidence. I’ve tried collecting petitions with tens of thousands of signatures from the Australian public. The father of cognitive behaviour therapy (CBT), Dr Aaron T Beck, wrote a letter to our former Minister for Health, Peter Dutton, suggesting that the system should be changed. None of these strategies have worked because there is no genuine political will about mental health from the big parties. Our political leaders in Australia are simply not willing to fix our broken system. The evidence from research will continue to pile up and our party will put it on display to support our calls for change.

If the big parties won’t listen, or don’t care what the research says, maybe think about voting for us instead. The Australian Mental Health Party will make these reforms a priority. Our five planks of reform to Medicare-supported psychological care are the first step in setting things right (find out more here). We’ll see you at the coming Federal Election.