Access to mental health care for millions of vulnerable and disadvantaged Australians is under threat. There is a proposal currently being considered by the Federal Department of Health’s review of the Medicare Benefits Scheme (MBS) which, if accepted, will have devastating consequences for Australian's access to mental health services, particularly those in rural and regional areas.
Medicare is the main funding program enabling the Australian public to access psychologists. In a nutshell, the proposal recommends that Australians seeking referrals for mental health issues should be restricted to seeing only 36% of psychologists (those primarily holding endorsements). The proposal wants only psychologists who have been “endorsed” in selected areas of practice by the Psychology Board of Australia to be able to claim Medicare benefits for clients presenting with moderate, severe or complex mental health disorders. Recent correspondence from AHPRA (our registration body) indicates that 'a non-endorsed psychologist may have a similar level of competency and qualification without having applied for an area of practice endorsement'.
Endorsed psychologists primarily operate in urban areas, while the majority of psychologists operating in rural areas are non-endorsed. The consequences to Australians in desperate need of mental health care will be disastrous. If accepted, this model will result in higher session fees, with clients unable to claim any Medicare rebate unless their preferred practitioner is “endorsed”. Market forces would likely push up out-of-pocket fees to see endorsed psychologists and waiting lists would blow out. By losing a major funding stream, many non-endorsed psychologists would be forced to close their practices, leaving vulnerable clients without access to vital and affordable health services. Many endorsed psychologists do not bulk bill, meaning only those in higher socioeconomic groups would be able to afford treatment for the most debilitating of conditions.
Our colleagues - Mental Health Social Workers and Mental Health Occupational Therapists, are also experiencing uncertain futures as their services are not even mentioned in this proposal. We can only speculate their exclusion - worst case scenario, they will be phased out from providing services altogether, while best case scenario they will be thrown into the third-tier of service provision with all non-endorsed psychologists (therefore being also severely restricted).
We have tried to reason with governing bodies and the government but we now need an official means of defending our livelihoods and profession into the future.....using the legal system. We already experience unfair division in rebates for our services in many programs (Medicare, DVA etc.) and we are restricted from providing diagnosis support letters to our clients applying for Centrelink payments.
Therefore, we have decided that we need to commence legal action ASAP to protect our right to provide services to the community and earn a livelihood. We have had enough taken away from us, our clients, and the communities we serve, and it must stop now!
The Australian Association of Psychologists Incorporated represents all psychologists (regardless of endorsement) and has a Legal Fighting Fund (Trust Account). We have raised just over $60 000 but need another $40 000 to commence legal action and protect the public's access to mental health services. The financial representative of the AAPi is Michael Pointer (Executive Director).
Fundraising team: AAPi and Australian Psychologists (3)