Australians accessed almost a quarter of a million fewer subsidised psychology sessions last financial year, prompting psychologists to urge the federal government once again to double the number available to patients and work to reduce high gap fees.
The latest government services data, released last Wednesday, showed the number of subsidised psychologist sessions had declined from 6.67m in 2021-22 to 6.43m in 2022-23.
Under the government’s Better Access scheme, patients with a GP-approved mental healthcare plan can receive a Medicare rebate of $93 a session with a general psychologist. The rebate increases to $137 a session with a clinical psychologist.
Australians accessing subsidised mental health services overall for the first time had also declined slightly year on year as a proportion, dropping from 26.4% in 2021-22 to 26.1% in 2022-23, the data showed.
The new figures coincide with a renewed push by peak psychology bodies and mental health experts to lower the cost barriers Australians face when trying to book a therapy session.
Survey data released by the Australian Bureau of Statistics in November showed the number of people who delayed seeing a health professional for mental health reasons due to the cost had increased to 19.3% in 2022-23 from 16.7% in 2021-22.
The Australian Psychological Society (APS), one of two peak national psychology bodies, said it is calling for the reinstatement of the extra 10 subsidised Medicare sessions a year for those with the most complex needs and establishing early intervention programs in the school system to address the trend.
The body’s chief executive, Zena Burgess, said its members have continued to report that patients were “rationing” their sessions amid the cost-of-living crisis.
“This troubling data shows that too many people can’t afford to see a psychologist when they need to,” she said.
“In a cost-of-living crisis, our most vulnerable should only need their Medicare card, not their credit card, to access psychology services. Making psychologists more affordable helps patients faster, while also reducing pressure on GPs, first responders and emergency departments.
“Reinstating 20 sessions for people with complex needs and those from disadvantaged groups will give people seeking help a better chance to thrive and live healthy lives.”
But the health minister, Mark Butler, has so far resisted calls to reinstate the Coalition’s Covid-era policy, instead saying the decision had “worsened” access to the cheaper sessions and resulted in many Australians living on lower incomes and in regional, rural and remote areas missing out.
The Better Access report, released in December 2022, showed the number of new people accessing psychology sessions fell by 7.25% between 2020 and 2021 and out-of-pocket costs increased from $74 a session in 2021 to $90 in 2022.
It found while the extra 10 sessions led to better outcomes, it “disproportionately” favoured people on relatively higher incomes in major cities. However, the review recommended the extra 10 sessions remain but instead be targeted towards those with “complex mental health needs”.
Butler said 43,544 more people had received Better Access sessions in 2023 compared with the same period in 2022.
“While this is a positive step, more work is needed so all Australians – no matter where they live or what their circumstances – can get the mental healthcare they need,” he said.
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“The government will continue to work with the sector and people with lived experience of mental illness to progress reform.”
An advisory committee, made up of experts and research groups, has been set up to evaluate the program and recommended changes to improve access and affordability. It has met four times since September 2023.
Meanwhile the Coalition and the Greens are calling for the immediate return to 20 cheaper therapy sessions a year, both pointing to the tough financial circumstances households are under.
The shadow assistant mental health minister, Melissa McIntosh, said figures from various reports painted an alarming picture of the growing mental health issue in the country.
She pointed to a recent Royal Australian College of General Practitioners’ Health of the Nation report, which showed 72% of GPs rated mental health in their top three reasons for patient presentations.
“Australia’s disease burden from mental health is amongst the highest in the world. Additionally, the mental health and cost-of-living crises are colliding,” McIntosh said.
“We’re seeing Australians with mental ill health being left behind with no affordable options after the Better Access cuts, as families struggle under this cost-of-living crisis.”
The Greens senator and the party’s health spokesperson, Jordon Steele-John, said bringing back 20 sessions was the “absolute least” the Albanese government could do to prevent people rationing 10 sessions over the course of a year.
“This is beyond crisis point. The government needs to explore other ways for people to get affordable mental healthcare, including expanding the range of mental healthcare professionals that can offer services through Medicare,” Steele-John said.
According to APS’s schedule of recommended fees, psychologists are recommended to charge about $300 a session, meaning the gap fee can range between $100 and $200.
