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For many Australians, rightly or wrongly, COVID-19 is already something that is spoken of in the past tense. At the height of its grip, federal and state governments took a range crisis measures, from JobKeeper and grants for businesses to providing shelter for the homeless and increasing the number of subsidised mental health appointments that could be claimed under the Better Access program from 10 to 20.
Yet even as these responses to the pandemic have been unwound, our post-COVID lives are proving there will be no simple reset. Business failures and cost-of-living pressures have mounted, and with them the stress and anxiety of coping with day-to-day life. In December the federal government decided to withdraw the extra 10 mental health appointments, citing their effect on waiting lists, and patients are now forced to pay a gap fee for 69 per cent of government-subsidised psychology services, compared with 53 per cent in 2018.
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In March John Brogden, patron and former chairman of Lifeline Australia, noted that before the pandemic and the Black Summer bushfires, daily calls to the service averaged about 2400 but they have risen post-COVID to 3800, something he called a new normal.
The Albanese government rightly points out that many of the factors driving rising costs are beyond its control. But as budget day approaches, one area where Treasurer Jim Chalmers should be looking to show increased ambition is in the provision of mental health services. If you can’t beat back costs, you should surely support Australians on the receiving end of them.
This is not simply a question of spending – we need to re-conceive how mental health services are delivered and recognise differing needs across the nation. As Rachel Green, chief executive of the mental health charity SANE, has put it: “We need a smarter system that is not just clinical – [there needs to be] psychosocial, housing, social and family support.”
In the short term, dealing with the cost of services means considering an increase in rebates and bulk-billing for mental health appointments so that access is not limited to those who can pay. In the longer term, we need to expand the workforce in this sector. The Brain and Mind Centre has called for at least 200 additional Commonwealth-supported university places for clinical psychology each year over the next four years to meet growing demand.
To take pressure off the NDIS as a source of assistance, it will also be necessary to improve accessibility. Australians in rural and remote areas are underserved and incentives need to be provided to relocate mental health professionals nearer to them.
But the type of service is as important as the location. For those with low-level mental health issues, Beyond Blue has advocated digital services and mental health coaches. In the so-called “missing middle” – between those people seeing their GP or a psychologist and those suffering from acute mental illness – some 2 million people are estimated to be in need of support. As NDIS Minister Bill Shorten put it recently, “there is a bit of a desert … There’s people who need more than a couple of sessions of therapy but are not sufficiently impaired that they require the NDIS.” The budget needs to step into this gap.
Helping the mentally ill is a measure of our ethical standards as a society. But it is far from being merely a charitable act. The effects of poor mental health are being felt across age and income strata, bringing with them increased treatment costs and loss of productivity and participation. It is time we stopped thinking of mental health as something intangible and rarefied and realised it is fundamental to physical and societal health.
In a recent television interview, Laura Strehlau, a Lilydale-based mental health advocate who lives with bipolar disorder – reminded us what our ambition needs to be. Access to subsidised psychology appointments had given her quality of life, she said, before adding: “It’s not just [for] crisis – it keeps us out of crisis.”
If we don’t plan for and invest in our mental health future now, we will be faced with a far larger, more costly problem down the track.
Patrick Elligett sends an exclusive newsletter to subscribers each week. Sign up to receive his Note from the Editor.
Lifeline 131 114
Beyond Blue 1300 224 636.
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