This chapter presents an analysis of the extent to which the Better Access initiative has impacted on the distribution of the allied mental health workforce – psychologists, social workers and occupational therapists in the early years following the introduction of the initiative. Better Access substantially expanded allied mental health professionals' access to MBS Items and, therefore, to the private (Medicare) sector. Prior to the implementation of Better Access, psychologists and occupational therapists had access to one MBS Item each (10968 and 10958 respectively), while social workers could not make claims on Medicare.
The increased access to Medicare warranted attention to the impact this might have on the patterns of distribution within the allied mental health workforce. Several issues were raised in the planning of the evaluation:
- Whether Better Access has had an impact on the distribution of each of the allied mental health occupations between the private (Better Access) and public sectors;
- The extent to which Better Access has had an impact on the numbers of Medicare Providers in each of the allied mental health occupations;
- Whether Better Access has had an impact on the underlying trend in the distribution of allied mental health occupations across the states/territories; and
- Whether Better Access has had an impact on the underlying trend in the distribution of allied mental health occupations outside of capital cities.
The analysis in this chapter is in four sections. Section 3.1 focuses primarily on trends since the implementation of Better Access in 2006 and examines the distribution of allied mental health professionals between the public and private (Better Access) sectors. Section 3.2, Section 3.3 and Section 3.4 provide a broader analysis and incorporate data from before Better Access, up to December 2008, to examine whether Better Access has had an impact on pre-existing trends within the workforce.
As this evaluation was undertaken just 2 years and 2 months after the implementation of Better Access, the impact on trends discussed in this chapter is preliminary. The full extent of changes created by the introduction of Better Access is unlikely to be realised within this time as there will be a lag period due to the length of training required to be a mental health professional.23
22 Given that data from Chapter 2 indicated that only a relatively small proportion of hours are spent providing Better Access services, and that there is only limited access to other MBS Items for the allied mental health workforce, it is likely that the majority of services provided in the private sector are provided outside of Medicare.
23 Issues relating to the training of the future workforce are discussed in Chapter 4.