The largest ever study into mental health services in Australia has found government programs are failing to give people in poor and remote areas equal access to help. The Monash University study looked at Medicare data relating to 25 million mental health items billed between 2007 and 2011. It found people who lived in disadvantaged parts of metropolitan areas, rural and remote areas accessed the least number of services despite needing them the most. In some cases, the top fifth of Australian society had about three times better access to some psychological services than the bottom fifth. In disadvantaged areas, people were more likely to be treated for mental health issues by their general practitioner or a general psychologist than a specialist like a psychiatrist or clinical psychologist. What treatment they did receive involved fewer visits than in advantaged areas. The number of mental health items that GPs billed for every 1,000 people in a one-year period was 79 in major cities, 25 in remote areas and eight in rural areas. The rate of clinical psychologist consultations was 68 for every 1,000 people in the highest socioeconomic status areas compared to 40 and 23 in the middle and lowest status areas. Researchers used freedom of information laws to gain access to the data.
The results, published today in the Medical Journal of Australia, come as industry advocates wait for the much-anticipated release of the Federal Government’s review of mental health services. The researchers said they hoped their findings stimulated debate on mental health reform. Lead research Professor Graham Meadows said they found the Government’s Better Access scheme had increased access overall to mental health services. “What this study’s looked at is the fact that that increase in access does not seem to be even across the country,” he said. “It’s different in rural and remote areas – it hasn’t increased to the same kind of level that it has in the cities. “This doesn’t look to me like the pattern you would be seeing if it was a truly generally universal, consistently fair system.” Professor Meadows said the field was eagerly awaiting the release of the Government’s review into mental health services. “The Federal Government’s had it for quite a while now,” he said. “I would hope that in it there is at least some consideration of this issue of equity.”
City services saved my life: patient
Growing up in rural New South Wales, Rebecca Delatorre had a 40-minute drive to the nearest hospital, let alone specialist services. “It all came to a crisis point unfortunately before anything actually happened for me,” she said. “I had my parents drive me into town where I was put into a ward where I remained for a number of months.” Ms Delatorre was diagnosed with paranoid schizophrenia, but it was only once she moved to metropolitan Melbourne that she got intensive therapy. With the help of medication she is now stable and studying at university. “It’s completely changed my life having access to this sort of care,” she said. “I really don’t think I would be here if I hadn’t had the intervention I had when I moved to Melbourne.” Ms Delatorre said there needed to be more services for young people in rural and remote areas. “We’re not making these resources available to those who truly do need them,” she said.
Call for more funds for mental health
The Black Dog Institute said it would like to see a whole-of-government approach to mental health. Clinical director Dr Josie Anderson said the sector would like to see more resources put into mental health with a particular focus on early intervention and prevention. “The burden of illness, about 15 per cent of that is attributable to mental illnesses and disorders, but around 8 per cent of the health dollar is spent on mental health,” she said. “Mental health services is not just about specialist psychiatrists and psychologists, it’s about e-mental health programs, it’s about GPs who are knowledgeable about mental health, it’s about access to specialists when one needs it via telehealth if necessary. “It’s also about access to recovery-focused services that can help one get back into work, get back into education, find suitable accommodation and so forth.” Dr Anderson said the Government could make better use of resources like e-health and telehealth programs to improve access to services for people in rural and remote areas. “It’s also important that we are smarter about the resources that we do have and how to enable better access to them,” she said.
This article first appeared Yahoo 7 News, 2 march 2015.