Clinical psychologists
Psychologists
Social workers

Clinical psychologists

Clinical Psychologist, Major City, VIC
1. The poor rebate for group sessions makes them untenable to run despite being highly effective and uniquely appropriate for children and adolescents, 2. Requiring a medical referral creates a major barrier - especially for adolescents. (#38)

Clinical Psychologist Major City, WA
An item for autism assessment has been brought to the BAMH program in that it pays less in a rebate to the client than a standard clinical psychology item ($78.40 for the autism assessment item versus $115.05 for the standard 50 minutes plus appointment). (#213)

Clinical Psychologist Major City, NSW
As a clinical psychologist I feel the client base under BAMH has been suitable to my training and experience. I worry that psychologists with less training and experience in mental health may not be providing the best-practice treatments to this client group. (#142)

Clinical Psychologist Major City, NSW
As a Clinical Psychologist working in a so called 'affluent area', I found that my bulk billing clients referred under a care plan was highly beneficial to many disenfranchised people in this community. All referring GPs are aware of this. (#110)

Clinical Psychologist Major City, QLD
Clinical Psychologists are trained in assessment, diagnosis and treatment of mental health issues. I do not believe patients should need a referral from a GP in which the GP assesses and diagnoses mental health issues as some GPs may have very limited training. (#300)

Clinical Psychologist Major City, WA
Far too many under-trained psychologists are getting Medicare numbers (i.e. they have no Masters degree and are not specialist psychologists) and are trying to treat people who are too ill for them to assist. The patients need specialist psychological care. (#214)

Clinical Psychologist Major City, WA
Feedback from patients tell me this initiative has made a huge difference to many people's lives enabling them to cope better in their respective circumstances. We must also be aware of what tragedies we are preventing in terms of suicide and long term s… (incomplete comment). (#271)

Clinical Psychologist Major City, NSW
I believe, through comments from clients and talking with other colleagues, that the Better Access Initiative is making a very big impact on the accessibility and affordability of mental health services for a large proportion of Australians with mental health. (#76)

Clinical Psychologist Major City, NSW
I bulk bill for the treatment of ex prisoners in an attempt to help them to integrate into the community and to lead productive lives. The recidivism rate for participants is 9% against 46% on a state basis for NSW thus saving the community many millions. (#169)

Clinical Psychologist Major City, WA
I do not consider GPs acting at gatekeepers as a necessary function in accessing psychological services. It is costly for the system and the review process is costly for the clinician and places client confidentiality at risk. (#416)
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Clinical Psychologist Major City, NSW
I practise partly in an Aboriginal Medical Centre and this helps access. There are difficulties getting interpreters for CALD people. One other problem is that many of the patients change GPs in the course of treatment. (#157)

Clinical Psychologist Major City, SA
I'm concerned about the quality of services provided by clinicians who are not clinical psychologists. (#98)

Clinical Psychologist Major City, WA
It is a very positive initiative enabling people to access psychological services who most need them and who have difficulty affording them. Significant improvements in their mental health are the direct result and very much needed. (#22)

Clinical Psychologist Major City, VIC
Limiting services for individuals to 12-18 sessions per year means treatment is often stop gap and inadequate. This population of patients, by definition, have significant issues which, to be adequately addressed, need more time. (#23)

Clinical Psychologist Major City, NSW
Medicare items allow for 12 and up to 18 sessions of individual therapy per annum. plus 12 group sessions. I suggest 24 sessions and up to 30 sessions per annum IRRESPECTIVE of individual or group mode. This is more therapeutically useful. (#80)

Clinical Psychologist Major City, SA
My responses "Don't Know" are based on lack of information on my part. (#151)

Clinical Psychologist Major City, QLD
Should be an item number for outcome and review reports for allied health practitioners. No need for patients to see GP for review, or in some cases initial referral. Perhaps up to 3 sessions without GP referral. (#106)

Clinical Psychologist Major City, WA
The BAI has been invaluable in helping people access mental health services and educating GPs on the importance of identifying mental health issues (considering the prevalence and 'costs' of these problems). The latent need for it was seen in the initial . . . (incomplete comment) (#210)

Clinical Psychologist Major City, WA
The initiative needs to take into consideration best practice guidelines for working with children and adolescents and allow sessions to be conducted with parents when the child is not present. (#262)

Clinical Psychologist Major City, VIC
The most co morbid, complex and severe level of depression, anxiety and other disorders are referred to clinical psychologists and these require far more than 12 to 18 sessions for evidence-based treatments. (#368)

Clinical Psychologist Major City, NSW
This initiative has made mental health care more accessible to financially challenged community members and also resulted in GPs and Psychologists working together more effectively in the community. (#107)

Clinical Psychologist Major City, QLD
This initiative should have started 30 years ago. It is evident from my experience that there are a significant number of people out there who need access to psychological services and over time this will be reflected not only in the improved mental health. . . . (incomplete comment) (#25)
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Clinical Psychologist Major City, WA
Two comments: 1) It adds to the expense of the system to have the Dr. do such an intensive referral when any competent clinical psychologist will do his or her own. The review similarly adds unnecessary expense for the system. (#156)

Psychologists

Psychologist Major City, WA
Counselling psychologists are 6 year trained Master's or PhD graduates and should have access to Tier-1 Medicare rebates that Clinical psychologists do. 42% of counselling psychologists are in private practice and the government is not making good use of. . . . (incomplete comment) (#209)

Psychologist Major City, NSW
GPP referrals are often missing vital information. Sometimes there is no paperwork at all!! There is also a confusion amongst GPs as to the period of time in which referrals can be made. The erroneous perception is that it is from, eg, August to August. (#413)

Psychologist Major City, ACT
GPs do need more information about diagnosing Mental Health disorders. All health professionals involved in this initiative need more networking opportunities. (#113)

Psychologist Major City, WA
I am advised that many service providers do not have appropriate training in the mental health conditions or indeed in mental health counselling. This is a serious concern and should NOT be addressed by one day workshops. (#288)

Psychologist Major City, VIC
I am frustrated at the demarcation between clinical psychologists and registered psychologists. My clientele I imagine is identical to that of a clinical psychologist. It is time that someone really examined quite objectively the purported difference. (#119)

Psychologist Major City, WA
I believe that generalist psychologists who can provide evidence of clinical practice from peer reviewed client files should be allowed to register as clinical psychologists. (#65)

Psychologist Major City, VIC
I get concerned that people who can afford services are directly referred. I don't believe GPs are reviewing that aspect of things, perhaps it is not within the scope of the scheme, eg. not means tested in any way, or had been considered by Government .(#75)

Psychologist Major City, WA
I have people fly or drive from rural communities to see me or others in my practice. It would help them enormously if telephone counselling, particularly by skype (VoIP), could be included in the Initiative. (#143)

Psychologist Major City, VIC
I have the impression there are already too many psychologists now in private practice, competing to obtain referrals from a limited number of GPs. However, the service distribution (of psychologists) appears to be concentrated in the inner city and. . . . (incomplete comment) (#61)

Psychologist Major City, NSW
I work in a low income, high unemployment area and bulk bill a large percentage of my clients who would not have access to individual mental health services if they did not have the Medicare subsidy. (#186)

Psychologist Major City, NSW
It's difficult to ascertain the impact of the BAI when working with a restricted sample of the population. The prevalent belief among psychologists, which I share, is that the BAI has contributed to de-stigmatising mental illness by making services more affordable. (#28)
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Psychologist Major City, NSW
Level of Medicare rebate gives false impression that this is a satisfactory level of remuneration and/or income for professional psychological services provided in the context of private practice costs. Awareness raising about this could be a suitable. . . . (incomplete comment) (#94)

Psychologist Major City, NSW
Many GPs are still not knowing about the Better Access Initiative. (#131)

Psychologist Major City, WA
Only about 1% of clients are initially referred by GPs under this programme. The rest are people who contact me about an appointment and then on my advice they go to their GP for a formal referral. These people seem to seek out assistance from a psychologist. (#150)

Psychologist Major City, ACT
The BOMHC initiative has enabled low income earners, unemployed, pensioners, etc. to receive quality psychological care where they would not have been able to access this in the past. This is the best thing to be introduced to the Australian people since . . . . (incomplete comment) (#171)

Psychologist Major City, VIC
The key issue is getting people with mental health problems to seek help. Privacy and confidentiality is thus important. Requiring a GP referral adds a further hurdle that is off-putting to many who value privacy. The fact that a huge amount of the budget. . . . (incomplete comment) (#32)

Psychologist Major City, VIC
The lack of ability to use interpreters is a major concern for NESB patients. For children and adolescents, private practice may not always be the most appropriate place. For psychologists working in high NESB communities and low SES, there is considerable . . . . (incomplete comment) (#114)

Psychologist Major City, NSW
The narrow range of supported therapies is not necessarily in patients' best interests, as some may benefit from more appropriate therapies that are not included under Better Access protocols. (#146)

Psychologist Major City, VIC
The provision of 6 to 12 sessions for many psychological issues is unrealistic. particularly for drug and alcohol related issues. and it seems to me that this arbitrary figure is wrongly setting up expectations that mental health issues ought to be 'fixed.' (#42)

Psychologist Major City, QLD
The referral system through GPs is good as they obviously see a lot of people who suffer from mental health problems and can direct them to assistance that the patient otherwise may not access. However the review process for psychologists (reports after. . . . (incomplete comment) (#26)

Psychologist Major City, WA
The survey doesn't really capture the problems with the Better Access Initiative, nor the issues around how it is being (mis)used. For example, "access" may have improved, but quality has reduced: Many GPs seems to have a standard practice of diagnosing . . . . (incomplete comment) (#237)

Psychologist Major City, QLD
The system procedures are limiting GPs and psychologists from using the program. (#96)

Psychologist Major City, NSW
There are great impediments for providers who wish to bulk bill including the lack of resources in GP software to add on psychologists, making it at least a five week wait until being paid. If the government. wishes psychologists to consider bulk billing for . . . . (incomplete comment) (#144)

Psychologist Major City, QLD
There are too many restrictions in the program for assisting children - child clinical work often involves working with the parents or conducting family therapy rather than seeing the child on their own which is a condition of the scheme. (#95)
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Psychologist Major City, QLD
The Better Access initiative has made access to mental health services more accessible for many people who couldn't previously afford the services and it has made it more practicable for mental health workers to provide services to disadvantaged people by . . . . (incomplete comment) (#102)

Psychologist Major City, QLD
This initiative has been instrumental in providing quality support and treatment for ordinary Australians struggling with the impact of a mental disorder. Almost all of my clients could not access such care and treatment without the access to Medicare . . . . (incomplete comment) (#33)

Psychologist Major City, SA
This initiative has not only allowed those unable to afford/access services, it would seem to have a preventative effect for people graduating to more serious mental health problems. (#218)

Social workers

Social Worker Major City, VIC
Access for CALD people depends on availability of bulkbilling practitioners like me. (#327)

Social Worker Major City, VIC
Always chasing up appropriate referral information from GPs such as referral letter, they usually send copy of MHCP. Constantly educating GPs and informing them that I have the same clinical skills as a Psychologist, and have to prove myself to GPs . . . . (incomplete comment) (#399)

Social Worker Major City, NSW
As a private practitioner, I notice that the people coming to me are not substantially different to those who came previously. They seem to be largely people who know how to get access to resources that they would otherwise have paid for themselves. (#8)

Social Worker Major City, VIC
As a Social Worker with a Masters Degree in Child and Adolescent Psychotherapy, I have worked in private practice for over 20 years. My practice concentrates on treating children with complex mental health needs such as anxiety and depression, suicidal . . . . (incomplete comment) (#363)

Social Worker Major City, QLD
As a social worker, I am as yet uncovered by private health insurers. The inclusion of social workers in the Better Access program has enabled me to ensure access and equity to my clients. For economically disadvantaged clients, I now bulk bill, which has . . . . (incomplete comment) (#347)

Social Worker Major City, VIC
Can we have some additional items like case management, family work, more sessions before report is needed, payment for reports and missed sessions. Same payment for social workers as psychologists and additional refunds for practitioners who solely bulkbill. (#162)

Social Worker Major City, NSW
Children and adolescents are being referred as patients. Often the best treatment is to educate parents about how they can assist their child but the parent does not have the referral . . . . (incomplete comment) (#394)

Social Worker Major City, VIC
Clients have commented that they would not have been able to access counselling without the GP referring them through this program. (#269)

Social Worker Major City, NSW
Firstly, I am concerned that the seriously mentally ill are being referred to private practitioners who are not able to manage them effectively and safely in the community. We need to absolutely ensure that community based services are ALSO adequately . . . . (incomplete comment) (#280)
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Social Worker Major City, WA
For many clients it has 'mainstreamed' primary mental health care and been the tipping point for many to seek help when they may not have previously, or might have waited for a major crisis before being medicated, hospitalised or separating or divorcing. (#379)

Social Worker Major City, VIC
I am unsure if indigenous and CALD patients are accessing services as I haven't received any referrals for these patients. I would also like to say that 12sessions with the possibility of another 6 is very limited and that there are times when the . . . . (incomplete comment) (#410)

Social Worker Major City, VIC
I am very unclear why mental health social workers providing focused psychological strategies are rebated less than registered psychologists. It would help us as a professional group to be treated fairly. (#276)

Social Worker Major City, VIC
I can only comment on my client load, I am seeing older people, people who have come for the first time, and those who have sought help at earlier times and now have a little extra help to help with current stresses. (#285)

Social Worker Major City, VIC
I have some reservations about the 'appropriateness of services' and 'better outcomes' under the initiative. I strongly support the initiative but believe that the treatments available under it are too limited both in the treatment modalities offered as . . . . (incomplete comment) (#258)

Social Worker Major City, SA
I think it an excellent initiative and believe many patients are benefiting from it enormously. I bulk bill most of my Better Access patients and many of these people are getting assistance where they would not have access to the public system or some . . . . (incomplete comment) (#283)

Social Worker Major City, ACT
I use Better Access as a bulk billing opportunity for clients who may have multiple issues and do not readily fall into public mental health categories (ie not e=acute enough). A major issue is 'do not attends' - which has in the past 6 months halved my . . . . (incomplete comment) (#415)

Social Worker Major City, NSW
It's very difficult to network with GPs about services a mental health social worker can provide and why they would choose to refer to one over a psychologist. (#318)

Social Worker Major City SA
My suggestion is to include family therapy in the Better Access program. I feel families as part of treatment process need to be included as well along with individual therapy. (#250)

Social Worker Major City, VIC
Some people are concerned that private health insurers will be able to know they have accessed mental health services under the Better Access Initiative - and therefore don't access the service or pay the full fee despite being financially stressed. (#330)

Social Worker Major City, QLD
The anomaly between social work and clinical psychology and psychology rates needs to be removed. Most Mental Health social workers enter private practice after many years of practice and experience in the public sector and are very skilled. (#378)

Social Worker Major City, NSW
The report writing requirements are excessive and extremely time consuming, a standard pro forma document needs to be created and applied across all disciplines. The rebate for social work needs to be in line with psychology. (#313)
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Social Worker Major City, WA
There is a reluctance by GPs, Psychiatrists and Mental Health Services to refer to Clinical (Mental Health Social Workers) because they do not know that we have special, adequate and relevant training and experience to provide mental health services. (#337)

Social Worker Major City, QLD
There should be equity in financial remuneration for practitioners, eg. Social workers providing services under this scheme should receive the same payment from Medicare as clinical psychologists do. (#376)

Social Worker Major City, VIC
There were already many appropriately qualified and skilled practitioners before this program. The value is in making it accessible to all. The financial circumstances of my referrals has not changed under this scheme. (#292)