When cuts to mental health care happened last year, most people made the same mistake we did. We brought attention to the name of the program being cut, to raise awareness. But there’s a much bigger issue at stake – and that issue is the fact that now if you’re a person seeking Medicare support for a mental health condition, you’ll receive less appointments. Last year, support from Medicare dropped from 18 to 16 appointments, with the last 6 sessions becoming more difficult for people to access. Next year though, the Federal Government plans a much bigger drop. Medicare support will plummet to just ten sessions of psychological treatment, with no exceptions.
Politicians said all of the cut funding would be re-invested in a better way to improve mental health services. The unfortunate reality is that access to treatment has been dramatically reduced and the other services where funding is being redirected to are out of reach for most people in need of support.
To make matters worse, nobody bothered to show how the re-directed funding would improve things. It was left up to mental health professionals and concerned members of the public to do their own calculations, scratch their heads, and then realise that something was wrong. A lot of people complained about the decision (including the Alliance for Better Access), but it was difficult to articulate in simple terms why the re-direction of funding was such a mistake. With that in mind, I decided recently that I should give this another try, so that you can all see why we need Medicare support for psychological treatment.
The main program where funds are being re-directed to is the Access to Allied Psychological Services (ATAPS) scheme, and the first thing most people will notice is that treatment in the ATAPS scheme typically costs between $70 and $120 per session, although it can range from $57 to as high as $631 per session. The typical cost per service is not much different to the rate for treatment services in the Better Access initiative, which is between $83.25 and $122.15 per session. The biggest difference is that between 15% and 25% of all funds allocated to ATAPS are spent on administration functions. In the Medicare system, all of the allocated funding goes to psychological treatment.
If we take this from the point of view of a person seeking psychological treatment, there are two ways to look at this. First, this difference in figures translates to reaching 15% to 25% fewer people. Second, if we look at this from the vantage point of an individual, these figures translate to having access to 15% to 25% less appointments. In other words, if the costs are about the same in both programs, then re-directing 15% to 25% of funding away from psychological treatment means that people with mental health conditions receive less treatment services under ATAPS.
A performance report for the ATAPS scheme that was carried out by the Australian National Audit Office in 2011 provides the best information to check these facts. The audit shows that since ATAPS was launched it has received over $150 million in funding and has delivered over 900,000 mental health sessions of care to 170 000 people with a diagnosed mental health disorder (pp. 13-14). This amounts to a cost of $166.67 per appointment. Dividing those funds across 170,000 people who access the scheme, this figure comes to $882.35 per person, providing 5 appointments (the average utilised in the ATAPS scheme). By comparison the Australian Institute of Health and Welfare released a report last week indicating that 916,700 people access psychological treatment in Medicare each year. Even going by the most inflated estimates of the costs at around $550 million per year, this only amounts to $599.98 per person. There’s quite a difference between roughly $880 per person and $600 per person, especially when we consider the hundreds of thousands of Australians who need psychological treatment each year.
ATAPS is clearly more expensive to run, but that’s the way it is meant to be. In previous years we have all acknowledged that the ATAPS program is a smaller and more expensive program to run, because it picks up those areas which are not reached by Medicare. Medicare Benefits Schedule (MBS) items don’t receive as much uptake from disadvantaged groups and difficult to reach areas of our society, across practically every area health care. It costs more to reach these groups, but that does not mean we should be cutting services for all people with mental health problems seeking help via Medicare. The Department of Health and Ageing sum it up quite aptly:
Better Access achieves a rural and remote service rate comparable to other MBS items of approximately 25%, possibly reflecting that the uptake of the Better Access initiative has been considerably less in rural areas than in urban. This suggests that ATAPS and Better Access are operating in a complementary fashion to meet the mental health service needs of Australians.
So as you can see, it makes no sense to cut funding from the Better Access initiative to redirect it towards ATAPS. We need both of these programs. We should not be sacrificing the care of patients who are looking for Medicare support for their psychological treatment. If anything, both of these programs need to be expanded to provide better support for people in need.
What YOU can do to help
Right now we urgently need as many of you as possible to sign our petition before the end of the month. Our target is 10,000 signatures, and between our online petitions and hard-copies, we only need a few hundred more to reach our target. Stand with us on this issue and we will lodge our petition in parliament. Every voice makes a difference!