Depression is particularly prevalent in women around twice that of men. While therapeutic counselling can be a highly effective form of treatment, the cost of such services has traditionally been a barrier for many women.
In November 2006, the Better Access Initiative was introduced as part of the Medicare Benefits Schedule (MBS), allowing patients suffering from mental health problems to receive up to 12 mental health services a year, including consultations to psychologists, social workers, and occupational therapists. While data suggests strong uptake of MBS mental health services, little is known about the characteristics of people who use them. As such, it is unclear whether the scheme is helping to address inequities in access to mental health treatment.
The aims of this study were to assess women’s uptake of MBS mental health services (particularly those with mental health problems), to compare the characteristics of women who have and have not used the services, and to investigate the impact of the items on the costs of Medicare services.
The study involved analysis of longitudinal survey data from the Australian Longitudinal Study on Women’s Health (ALSWH), involving three cohorts of women, who were aged 28-33, 55-60, and 80-85 when the Initiative was introduced, linked with Medicare records from November 2006-December 2007.
- A large proportion of women who reported mental health problems made no mental health claims. Among women who reported depression, anxiety or another mental health condition on the most recent survey, only 12% of those in the younger cohort, 10% of the mid-age cohort, and 1% of the older cohort had used MBS mental health services.
- Socioeconomically disadvantaged women were less likely to use the services, despite mental health needs.
- Among women who used the services, very few had previously reported seeing a counsellor, psychologist or social worker, suggesting that the scheme has reached women who were not previously accessing mental health care.
- Uptake of services was associated with a steep increase in average yearly costs for women ($100-$150), and government ($600-$800).
Although there has been rapid uptake of mental health items, uptake by women with mental health needs is low and there is potential socioeconomic inequity.
Citation: Byles J, Dolja-Gore X, Loxton D, Parkinson L, Stewart-Williams J, Women’s uptake of Medicare Benefits Schedule items for psychologists and other allied mental health professionals. Medical Journal of Australia, 2011: 194: 175-179