A year after the government halved psychology subsidies, Australians are delaying or foregoing treatment

Ms Mason says the government could do more to help her son.  (ABC News: Liam Patrick)

Since rebates for psychology sessions were halved a year ago, the cost of living crisis has forced Australians to compromise and even forego critical mental health care.

For Kate Mason, the cost of therapy for her son has led them to move to a cheaper rental and prevented her from seeing a psychologist herself.

“There’s been so many little things that have had to change so he can get treated,” she said.

Her son was diagnosed with post-traumatic stress disorder in mid-2022, after an assault.

To optimise his recovery, his psychologist recommended weekly sessions for 12 to 18 months.

But at the beginning of last year, when the number of subsidised sessions in the Better Access Scheme was cut from 20 to 10, they had no choice but to visit fortnightly instead, which would ultimately prolong his recovery.

“The thought of trying to find the money for weekly appointments for my son, I just knew I couldn’t do it,” Ms Mason said.

“I was so angry and scared, really really scared.

“Twenty meant we could just do it, 20 meant he’d get to the half-year point and we’d work something out.

“But 10, 10 isn’t even one a month.”

Ms Mason was desperate for mental health to be treated like other areas of the health system.

“If you’re given a script for antibiotics, you don’t take a quarter of the script, you make sure you actually take the whole script,” she said.

‘It’s prolonged their therapy’: Psych

The extra sessions were introduced under the former federal government in response to the COVID-19 pandemic.

The current government chose not to extend the extra sessions into 2023 after it received a report into the Better Access scheme.

The Better Access Review found people on higher incomes were more likely to use the subsidies, but crucially, it told the government not to cut the sessions, and instead to target the scheme towards those who were missing out.

The president of the Australian Clinical Psychology Association, Caroline Hunt, said the government should have offered an alternative to patients needing prolonged treatment before making the change.

“I think to cut off before having those things in place has actually been problematic for many people with quite complex mental health disorders,” Professor Hunt said.

Clinical Psychologist Elizabeth Seely-Wait, who runs two clinics in northern and western Sydney, said the change had a profound impact on many of her clients.

“Our clients have to space out their sessions such that they have many weeks in between … it’s prolonged their therapy,” she said.

Shadow Health Minister Anne Ruston said it affected 240,000 Australians who were accessing the additional 10 sessions.

“In any other medical situation, half delivering a treatment plan as prescribed by your medical practitioner would be completely unacceptable,” Senator Ruston said.

Extra 40,000 people accessing subsidised sessions

Department of Health data showed an extra 43,544 patients entered the Better Access program after the change, whereas between 2021 and 2022 there was a decrease in the number of new patients receiving the subsidies.

Health Minister Mark Butler previously said that, under the COVID scheme, a large number of people in poorer and rural communities who needed support were not getting it.

But of the new patients who entered the program, there was no geographical breakdown provided to the ABC.

“The evaluation of the program showed it worked well for people who are able to get access to it, but it is highly inequitable,” Mr Butler said on Sunday.

“There are significant parts of Australia, particularly lower socio-economic suburbs in our cities, and particularly rural and regional Australia, have very little access to this at all.”

Health Department figures showed the proportion of those using the program in rural and regional areas stayed the same in 2023 as the years before, at nine per cent.

The ‘missing middle’

After a year of consultation, the government last year announced $456.7 million over five years for crisis support services like Beyond Blue, Lifeline and Kids’ Helpline.

Mr Butler said that was the first step of new reforms to the mental health system.

But the government has not yet announced any alternative changes to Better Access promising it would do so, and has not formally responded to the Better Access Review.

A spokesperson for Mr Butler said an expert advisory committee had been set up to consider a response to the review, but did not suggest a timeline.

Professor Hunt said that doesn’t help those who need longer-term or more intensive care.

“Additional crisis care is always going to be very helpful, but it’s not enough; there are quite a large cohort of people that have been referred by others as the missing middle,” she said.

“They are people who the severity of their problems is too much for primary care but not severe enough to access state services.”

Labor MP Josh Burns previously raised his concerns about cutting the sessions and said he was worried about the impact it was having on that cohort.

“For people to be forced to pay hundreds of dollars to access mental health care … that will mean that people are choosing not to access mental health care,” he said.

Kate Mason said her son was one of those stuck in the middle and she was desperate for the government to do more to help.

“If your child had a broken leg it would be covered by Medicare, if your child’s assaulted and has PTSD, you don’t have that money, Medicare doesn’t even come close to treating them,” she said.