Child sexual abuse survivors will be at greater risk of suicide under planned Medicare changes that will increase health costs because they will not be able to afford mental health treatment, psychiatrists say.
The Medicare safety net provides additional Medicare benefits to help people pay for out-of-hospital doctor visits and tests, including psychiatry and radiotherapy services, ultrasounds and X-rays after they reach certain thresholds of appointments.
The Turnbull government hopes to save $270 million by reducing the Medicare rebate for some services under plans contained in this year’s budget, which are planned to take effect next January.
Dr Paul Foulkes, spokesman of the Psychoanalytic Psychotherapy Association of Australasia, said the changes will raise the out-of-pocket cost from about $30 to $107 a session.
“This is not affordable for most people, let alone people on welfare or low-income holders,” Dr Foulkes said.
This would contradict the Royal Commission into Institutional Responses to Child Sexual Abuse’s recommendations last week that survivors should receive unlimited psychological treatment throughout their lives.
Child abuse survivors suffered severe psychological problems including chronic depression, post-traumatic stress disorder and anxiety, Dr Foulkes said.
They had difficulties maintaining family and work relationships and often required twice-weekly psychiatric treatment for a number of years: “Without it, either their progress will be stalled or, more likely, they will go backward and have a return of symptoms such as … suicidality and self-harm.”
Louise Roufeil, the Australian Psychology Society’s professional practice manager, said psychologists were concerned patients would have to wait longer to reach the safety net “and when they get there it will provide reduced benefits”.
Patients with chronic conditions, who were more resistant to treatment, were most likely to be affected by the changes, which would move treatment into a “user-pays system”.
People can currently attend up to 10 counselling sessions if they are referred by a GP, but this was often not long enough to treat to such severe conditions, she said.
“[Psychologists will] often spread them out across the year which isn’t ideal … some will reduce their fees, some provide pro bono services or the client pays.”
The royal commission recommended in its report this week a $4.01 billion redress scheme for about 60,000 survivors. The government should remove any restrictions on the number of counselling sessions for survivors under the scheme and expand the range of Medicare-funded psychological services, it said.
Adults abused as children had a higher risk of mental health problems compared with the community as a whole, it said in a report. “Some survivors require intensive psychiatric care, sometimes throughout their lives, including in inpatient mental health facilities.”
Health Minister Sussan Ley said the budget measure aimed to make the current system “easier to access and understand” for patients.
“The current system is overly complex and this measures aims to ensure more people can access the protections of the safety net sooner if they get sick,” she said.
She would not be drawn on when legislation on the changes would be introduced, saying consultations with patients and health professionals were continuing.
This article first appeared on ‘Sydney Morning Herald’ on 20 September 2015.