The latest health ‘snapshot’ of the 33 OECD (Organisation for Economic Co-operation and Development) nations has revealed that Australia is now the second-highest prescriber of anti-depressant medications.
Australian use of anti-depressants has doubled over the last decade – Iceland is the only country that has a higher rate of the use of the drugs – and several health experts say doctors are under pressure and over-prescribing.
Professor Philip Mitchell, the Head of the University of New South Wales School of Psychiatry, says it indicates that over-prescription of the drugs is now a problem in Australia.
“This concerns me that this is too much. We know that for milder levels of depression that psychological treatment, psychological therapy [is] very effective, and in Australia we do have a system for this through the better-access scheme, so it surprises me that the rates are continuing to go up,” he said.
According to the report, the rates of anti-depressant prescriptions in Australia appear to have doubled between 2000 and 2011.
Eighty-nine Australians in every 1,000 are now prescribed some form of daily anti-depressant, but 10 years ago the rate was closer to 45.
“A number of years ago we published figures suggesting that there were reasonably healthy rates of prescribing because we saw that anti-depressants were in fact reducing suicide rates, but I think this continued prescribing is suggestive of over-prescription,” he said.
We know that for many GPs they can only spend eight to 12 minutes with a patient and it’s simpler to write a script for that time.Professor Philip Mitchell, UNSW School of Psychiatry Head
“I wouldn’t be suggesting that we feel that all prescribing is inappropriate but I think these rates are starting to become concerning that perhaps too much is occurring.”
Mental health advocate and former Australian of the Year Professor Patrick McGorry says he is surprised at the prescription rates.
“In Australia about 10 years ago a better-access scheme was brought in and so access to psychologists is provided through Medicare now, which is unusual in any of these countries, so it’s a bit of a puzzle why it would be going up at this rate,” he said.
“One factor that might be relevant is that better access was reduced in scope a couple of years ago, so the number of sessions funded under better access was reduced from a maximum of 18 down to 10. I wonder if that’s playing some role here, but it wouldn’t be the full explanation.”
But Professor McGorry says the time pressures placed on GPs may be a factor as well, something Professor Mitchell agrees with.
He says the increased awareness of mental-health issues among medical professionals in combination with time pressures may result in GPs turning to the prescription pad.
“My impression is that they really feel they need to be doing something but there is that pressure. We know that for many GPs they can only spend eight to 12 minutes with a patient and it’s simpler to write a script for that time,” he said.
“But I think what these figures are suggesting is that they should be taking a little more consideration. You know, it may be getting the patient back to talk to them later but it suggests that the option of moving to the prescription pad is happening much too quickly.”
Both experts say a review of the Australian mental health system is long overdue.
So, does Australia have an over-prescription problem? Leave your thoughts and observations below in our comments section.
This article first appeared on ABC Radio’s AM Program and Online on 22 November, 2013.