Last week the health budget was released, which came just after a recent review of the Better Access initiative. Psychologists had been waiting with keen anticipation to see how the government might improve mental health policy, informed by this recent study. But despite the fact that the review gave a glowing report attesting to the successes of the Better Access initiative, the government's new proposal is to slash the number of allowable sessions for psychological treatment in half. It's time to take action now and tell the Federal Mental Health Minister what you think of this decision!
I strongly urge everyone to write a letter this time - not just psychologists, or other mental health professionals, but also consumers, concerned family, and any other person with an interest in mental health care. The message needs to be clear that the policy to impose a 10 sessions cap on therapy is a big mistake and must be changed immediately. Interested? Then send a letter to the Minister. To make this easy, I have some standard letters below to re-word or use as you like:
Sample Letter from a client/other
Sample Letter from a Psychologist
If you want to write your own letter (which I would strongly encourage), here is the postal address to send it to:
The Hon Mark Butler MP
PO Box 2038
Port Adelaide SA 5015
If you prefer email or you want to make sure your letter gets there, here is the Minister's email address:
In addition to writing a letter, please also consider joining our Facebook Group and signing our online petition at change.org
Below are three main points that you might consider putting in your own letter. These are just my own ideas, so please feel free to add to these or change them as you like. And if you have a really great idea you would like to share for the letter writing campaign, please add it as a comment below this post.
'A Half Baked Solution'
- The proposal to cap the number of sessions at 10 effectively halves the length of treatment available to a person under Better Access. The 10 session cap limits psychological therapy to half the recommended amount for even the most uncomplicated psychological conditions.
- Research from both the Australian Psychological Society and Harnett et al. (2010) shows that around half of the people who receive psychotherapy via Better Access will need more treatment.
- Focusing on psychosis and severe disorders is very important, however, it is only half of the problem. The other half is to keep investing in those areas that work already.
- This new policy only addresses the concerns held by half of the professional groups in mental health care. The views of psychologists and GPs have not been factored into the equation. We need a collaborative approach to mental health care that addresses the concerns of all mental health professionals involved in the system.
- The Better Access system in its present form splits the profession of psychology in half. Despite the recent Medicare review finding no evidence at all to justify the basis for having a two-tiered system that incorrectly classifies psychologists as being either 'generalists' or 'clinical psychologists', the government has left that faulty system in place.
- Mental health services are now being split in half again by claiming that the Better Access system is for mild disorders and ATAPS is for severe disorders. The evidence has repeatedly shown that 80% of people who access the Better Access initiative have moderate to severe mental health issues. Splitting up mental health services in this way is baseless.
'Ignoring the Evidence'
- Changes to the Better Access initiative amount to dismantling a system that has been shown to work. The Medicare review indicated that Better Access was cost effective, far exceeding expectations about the value of mental health care provided in this program. Introducing these severe new restrictions will have a measurable impact on a the quality of care that can be provided, and in doing so, will do measurable damage to an important component of mental health care in Australia that is working just fine the way it is!
- Psychological outcome research demonstrates that capping therapy at 10 sessions is unrealistic. Even when we look at figures from research conducted by the government, we find support for the length of psychological treatment needing to be closer to 20 sessions. For example, the Department of Health and Ageing funded a review of psychological interventions conducted by the Australian Psychological Society, showing that the minimum standard treatment is 12 sessions, and that most psychological interventions for depression and anxiety span 15-20 sessions.
- Professor John Mendoza has claimed that most people don't use more than 10 sessions in the Better Access system. If this is true, then why not let that decision be made between the client, their mental health professional, and their GP? If people are not accessing more than 10 sessions, then it will not cost any additional funds to allow the level of psychological care be decided between the individual and the mental health professionals they consult with.
- Capping the number of sessions with a mental health practitioner at 10 ignores clinical judgement and the choices of the individual about whether they need more treatment for their mental health condition.
'A Tough Deal for Mental Health Consumers'
- New investment in mental health care are welcome, but not at the cost of patient care in Better Access.
- Statistics indicate that most people accessing services via Better Access (75%) are consulting a mental health practitioner for the first time. This means that it takes people a few sessions to get the most from psychotherapy and develop trust and confidence in their psychologist. For people in a vulnerable psychological state, they will not be inclined to reveal their distressing thoughts, feelings and behaviours immediately. For many people, capping psychotherapy at 10 sessions will not give them enough time to work through their problems.
- Psychologically distressed people do not need the added pressure and stigma associated with needing to recover quickly.
- The proposed changes seem to suggest that when a person reveals to a mental health professional that they have a more complex or serious problem than was originally anticipated, they will need to get another referral from the GP to a different therapist to start again. It is difficult enough for a person in a fragile psychological state to reveal their problems in the first place, let alone making them start again with a different psychologist. Quite aside from how frustrating this will be for consumers, there are therapeutic implications here that will see many people simply give up.
- The new system creates more obstacles and red-tape for mental health consumers. This will obstruct people from seeing the practitioner they want to see and require more paperwork and appointments.
You may be thinking, "but this doesn't affect me - why should I care?" But this effects every single one of us. We all know somebody who struggles with depression, or anxiety, or a range of other psychological problems. They might not tell us about it, but there are a lot of people who battle with these issues and need a bit of support when they finally do bite the bullet and decide to talk to a mental health professional. Every Australian is affected by this lousy policy decision.
And if you are a psychologist who works outside of the Medicare system, have a bit of a think about how this new policy in Medicare will impact on the way your services are seen, wherever it is you happen to work. We have already seen attempts by bureaucrats in the Workers Compensation system and other areas to allow Medicare policies creep their way into other areas. If policy-makers are allowed to form this nonsensical idea that 6 to 10 sessions is a reasonable number of sessions to treat a psychological disorder, you can bet the same logic will find its way into other domains. Your area of work could be next.
So stand up and be heard people - every voice makes a difference!
Note: If you do send a letter, could you please either leave a short comment below to let us know, or forward/CC your email to