Based on feedback received from GPs, AHPs, consumers and carers, the key consideration was how to improve awareness of, and access to, mental health services for all sections of the community. The overwhelming view of GPs, AHPs, consumers and carers was that nearly all referrals were appropriate and clients received benefit from services provided by an AHP. Public mental health services recognised the value of the Better Access initiative but questioned how well it targeted scarce mental health resources relative to existing unmet need in the community. NGOs valued the contribution of the Better Access initiative to improved options for people with a mental illness, but expressed concern about the needs of people with more complex needs who may not be able to afford the gap payments associated with the Better Access initiative, and require a longer term period of support and intervention than is available through the Better Access initiative.
The strongest view supported by nearly all GPs, AHPs, consumers and carers was that strategies should be enacted to increase awareness of, and access to, mental health services through the Better Access initiative. AHPs, consumers, carers and NGOs reported the perception that GP awareness was the key impediment to improving access and that increasing GP awareness would increase the number of people being referred to AHPs.
Contrasting with the arguments to continue to increase access and utilisation was the view of stakeholders not as directly engaged in the Better Access initiative to consider strategies to better target services to populations most in need. While highly supportive of the Better Access initiative in addressing the needs of individuals with high prevalence disorders, a key concern underlying their view was that, in the light of high levels of unmet need in the community, resources could be better targeted to achieve equitable access and monitored to ensure effectiveness.
The consultation process identified a range of potential options to improve access for these groups including:
- managing the allocation of provider numbers on a regional or area basis to ensure service provision in disadvantaged areas;
- increasing the rebate and means testing eligibility to drive supply to lower socio economic areas;
- holding the rebate constant for existing items and increasing the rebate for services eligible only to selected population groups;
- funding and targeting ATAPS and MAHS to priority population groups;
- introducing secondary consultation MBS items for targeted population groups;
- introducing MBS items for telephone, internet and Voice over Internet Protocol (VoIP) services to residents of rural and remote communities or special need groups requiring particular language skills or cultural sensitivities; and
- introducing additional items for specific conditions and/or population groups.
Table 1: Options to improve effectiveness and equity in access
|Strategy||Low income earners||Remote areas||Aboriginal and Torres Strait Islander peoples||CALD communities||Older people||Children||Chronic and complex needs|
|Managing geographic allocation of provider numbers to enhance equity|
|Increasing rebate and means testing eligibility|
|Introducing outcome reporting to monitor effectiveness|
|Holding rebate constant on existing MBS items and introducing new MBS items for selected population groups|
|Enhance funding and target ATAPS and MAHS to priority population groups|
|Introducing secondary consultation MBS items for targeted population groups|
|Introducing MBS items for remote telephone, internet and VOIP services to rural and remote areas and special needs groups|