As an arthritis specialist, I see patients who require major treatment for decades. I’m not expected to limit my visits to 10 or 20. Under the Better Access scheme, patients are limited to 10 psychology sessions for their condition. Mental health treatments should be available for as long as they are needed.
The problems arise from several factors. Firstly, it has been forgotten that the scheme introduced in 2005 was aimed at mild to moderate conditions and therefore one could expect only a limited number of treatments would be required. Understandably, without alternatives, it has been used for complex conditions. Secondly, it was funded fee-for-service (rebate) with an option for the psychologist to charge a co-payment. That method of funding is fundamentally flawed.
Public hospitals and Aboriginal-controlled health services have salaried health professionals. No co-payments and everyone is seen, and time is limited only by the inadequate funding of governments, not the value of a patient’s credit card.
The suggestion that multidisciplinary care is not appropriate for complex mental health conditions would seem to suggest that inadequate housing, income, domestic violence and racism have no effect on outcomes.