Nearly all interviewees across all stakeholder groups reported that the Better Access initiative had been successful in facilitating access to appropriate and evidence based mental health care and achieving positive outcomes for clients. It was also perceived that services were being provided to the intended target groups and that assessment, eligibility and treatment guidelines were being complied with.

Interviewees highlighted that, prior to the Better Access initiative; most individuals with a mental health problem were either untreated or received very limited treatment options. Consumers and NGO service providers reported that for many patients, the only treatment option was that provided by their GP. A strong theme reported by all stakeholder groups in the consultations was that, since the introduction of Better Access, individuals with a mental health problem have the opportunity to access focused psychological strategies through the development of a comprehensive GP Mental Health Treatment Plan and referral to an AHP.

Consumers surveyed did not generally perceive any changes in the behaviour of their GP as a result of the Better Access initiative, and very few had had formal counselling sessions with them. Consumers interviewed generally had positive opinions in relation to their GP with very few (less than five per cent) reported strongly negative perceptions. Respondents critical of their GP were those who had no or very limited choice in GPs due to limited availability in their local area.

Limitations in the appropriateness of care provided were identified in relation to specific population groups and were perceived by AHPs to be a result of eligibility and administrative criteria relating to who can access services and the type of services that can be provided through the Better Access initiative.

GPs and AHPs working with individuals with complex needs, noted that these patients tended to require more intensive or different therapies than are covered by the Better Access initiative. In discussing this issues AHPs also noted that it was often difficult to identify clients with more complex problems on initial assessment as they often presented with a more straightforward condition such as mild depression or anxiety.

For children, AHPs working with children reported that the main constraint in the model of care related to the capacity to see the whole family or seeing the parents without the child present. It was noted that the Better Access initiative provides no MBS item for family therapy or seeing parents without the child being present.

Issues raised relating to working within Aboriginal and Torres Strait Islander communities and culturally and linguistically diverse communities related primarily to the requirements for cultural sensitivity and the time required to engage with and be accepted by the community in order to work effectively. GPs, AHPs and public mental health service providers working with these communities reported that, in many instances, the most appropriate intervention by a mental health practitioner may be to work with workers located in the community, providing secondary consultation services and liaising with these workers to provide broader support to the individual. It was noted that the Better Access initiative provides no MBS items for secondary consultation services or case planning services provided by AHPs.

Several AHPs working with rural and remote communities, Aboriginal and Torres Strait Islander communities, culturally and linguistically diverse communities and more complex and specialised treatment areas suggested that access and appropriateness of may be improved through the provision of MBS items for internet and telephone based therapy. This was identified as working well by several psychologists providing services of this type to residents in remote and rural areas and an Aboriginal counselling service providing telephone counselling.

There was also some questioning from some stakeholders as to whether the private practitioner model funded through the Better Access initiative is an appropriate model to engage with, provide services to and achieve the best outcomes for these population groups. These stakeholders considered that ATAPs or funding targeted to identified communities may be a more appropriate model.