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Almost half of all people who get 10 annual Medicare-subsidised therapy sessions use just three or fewer, leading the Productivity Commission to call for an urgent review of the Better Access Scheme.
It comes after the government announced in the October budget people would be able to access twice as many subsidised psychology sessions, taking the annual total to 20.
Peak medical bodies have defended the work of doctors in mental health treatment.Credit:iStock
The report was also critical of the current GP treatment model, saying many people were not accessing the right treatments.
The Productivity Commission report on mental health recommended the Better Access Scheme be "rigorously evaluated" as a matter of priority, as the drop-out rate showed many people were not accessing services that were right for them.
The Commission also estimated 10 per cent of people using those rebated sessions, who have moderate or higher-intensity needs, would benefit from further sessions, and recommended a trial on the number of provided sessions.
In October, Health Minister Greg Hunt announced the scheme would be increased from 10 sessions to 20 for anyone who needed them.
A spokesman for the minister said that doubling of sessions was a trial that will run until June 30, 2022, and the government would also be commissioning a review of that initiative.
"The expansion of Better Access also recognises that the impacts of COVID-19 may have exacerbated existing conditions for some people, leading to increased demand for services," the spokesman said.
"While currently just over 10 percent of people use more than 10 Better Access sessions, those that do are those most in need of more intensive psychological care and it is important that they have access to services provided under the initiative."
Doctors defend work as report says care often "below best practice"
The current mental health treatment plans should also be scrapped and replaced with an online diagnostic tool, the Productivity Commission report said.
The report also said while many GPs do a great job, some lack mental health skills and "rely too readily on medication as a treatment option".
Royal Australian College of General Practitioners acting president associate professor Ayman Shenouda said he welcomes any report that will improve patient outcomes, but defended the work of GPs.
"I think GPs are very well trained in mental health, the issue is about time," he said. "At the moment the patient Medicare rebate encourages shorter consultations, we have been talking to the government for years about how we have to give access to longer consultations."
Chairwoman of the Australian Medical Association's mental health committee Dr Danielle McMullen said the report seemed to be trying to have it both ways – acknowledging doctors are the "cornerstone" of mental health care, yet saying GPs don't do enough.
"Mental health care is complex, it takes time to get to know your patient, assess their true mental health state, it’s often over a period of time, and a good mental health assessment requires a good therapeutic relationship with your patients," she said.
"Replacing that with an online tool doesn’t fit with what the Productivity Commission wants with more patient-centred care."
Professor Gordon Parker, a psychiatrist and joint winner of the National Mental Health prize said many doctors were good at ensuring they gave their patients appropriate mental health care, but training needed to be weighted towards diagnosis.
"If you’ve got condition 'x', you end up with one therapist who gives drugs to everybody, and another therapist who gives everybody [cognitive behavioural therapy], that’s a really dumb model," he said.
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