The federal government is poised to go ahead with changes to the mental health system before November that will cut the maximum number of Medicare-funded psychological treatment appointments from a maximum of 18 sessions down to just 10 appointments. A few days ago, the government released the Medicare Benefits Schedule they plan to roll out at the beginning of November. These regulations will not be passed in law until they are tabled in parliament, however, with the end of the month soon approaching, it would appear that the government is planning to simply ram through legislation for the planned cuts to services to go ahead regardless of strong opposition from both the general community and all of the mental health professions. The opposition includes thousands of submissions to a parliamentary inquiry from concerned members of the public, a petition from the AMA with over 4000 signatures, another petition from the Alliance for Better Access with over 5000 signatures (ranked as the top active petition in Australia at gopetition.com), a GetUp campaign idea ranked 7th overall, surveys across all of the mental health professions indicating that most practitioners do not support the planned changes in funding, and letters pouring in from the community to the Prime Minister calling for a moratorium on the proposed changes.

The new Medicare Benefits Schedule reveals some additional surprises showing that the planned cuts are much more far-reaching than were previously anticipated. Shortly after the budget cuts were announced in May, the Federal Minister for Mental Health, Mark Butler, responded to concerns from psychologists and consumers with a statement that:

“People who need over 10 sessions of allied mental health services a year will still receive care through a range of other services including 50 psychiatrist services per annum through Medicare.”

The implication of this statement was that people who begin treatment in the Better Access program who require more than 10 sessions will be picked up by other areas of mental health care, such as the ATAPS program, where much of the funding that is being cut from Better Access will go. Pages 45 and 50 of the Medicare Benefits Schedule reveals that this is not the case:

“Services provided under the Access to Allied Psychological Services (ATAPS) should not be used in addition to the ten psychological therapy services (items 80000 to 80020), focussed psychological services-allied mental health services (items 80100 to 80170 or GP focussed psychological strategies services (items 2721 to 2727) available under the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule initiative per calendar year.”

In other words, people with mental health disorders will not be able to access further psychological treatment under the ATAPS scheme if they use up the 10 sessions that are available in the Better Access program.  The “range of other services” that Mark Butler was referring to seems to be limited to either 50 sessions with a psychiatrist per annum, or in the case of young people, to receive treatment in large centres such as Headspace or EPPIC. For young people who have established a working alliance with a therapist in the Better Access program, or those who have no interest in being seen anywhere near a big mental health treatment centre, there don’t seem to be any other valid options for getting help. For those who are over 25 and battling with severe depression, anxiety, or post-traumatic stress disorder, it would appear that the only option for more treatment will be to see a psychiatrist. The problem with that idea is that there are often long waiting lists to see a psychiatrist, and only some psychiatrists are willing or able to provide psychological therapy, with many practitioners now focusing on making a clear diagnosis and delivering appropriate medication to each client. Adults who need or prefer psychological approaches to recovery from mental health disorders are essentially being left to fend for themselves. The biggest concern is that amongst those people in our society who struggle with serious mental health problems, psychotherapy will only be available to those who can afford it, which will invariably lead distressed folk to disengage from seeking support and suffer in silence instead.

The question is why the government is not listening to the feedback they are getting from Australian mental health professionals, or more importantly, the people most affected by these cuts, living in our society. Instead, we seem to be putting policy in the hands of foreign agendas and the ideology of a few token psychiatrists who are currently dominating the media limelight. I reckon the Australian people deserve a bit better than that.