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Treatment rates for mental disorders

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The treatment rates for mental disorders in Australia has risen sharply, according to a new study, with experts attributing the jump to the introduction of a Federal mental health initiative giving patients access to a Medicare rebate for psychological treatment.

The study, led by Professor Harvey Whiteford of the University of Queensland‘s Centre for Mental Health Research, found the population treatment rate for mental disorders in Australia rose from 37 per cent in 2006-07 to 46 per cent in 2009-10.

The authors concluded that the introduction of the Commonwealth’s Better Access initiative, giving patients a Medicare rebate for mental health treatment was the driver for the increased treatment rate.

“The increase in the population treatment rate for mental disorders in Australia from 37 per cent in 2006-07 to 46 per cent in 2009-10 is remarkable by international standards,” their paper, published in Australian Health Review, said.

“No other country of which we are aware, has demonstrated such an increase within three years.”

The authors ruled out GP over-referral as a cause of the jump in treatment rates, saying that data on the severity of symptoms reported by people treated under the Better Access initiative showed that their treatment was genuine.

They said that based on the current trend they expected treatment rates to continue to rise unless there was some change to the Commonwealth-funded programs for mental health care.

“We also recognise that increased access to services is not sufficient to ensure good outcomes for those with mental disorders,” they said.

“It is also important to ensure that evidence-based treatment is provided to those Australians accessing these services.”

The paper said that mental disorders such as anxiety, depression and substance use are a leading cause of disease burden in Australia, but available evidence up to date had suggested that only a third of people with such disorders accessed treatment.

“Untreated disorders incur major economic costs and personal suffering,” the authors said.

Up until now it had been challenging to estimate the proportion of people with mental disorders who receive treatment for them.

With this study, Prof Whiteford and his team used survey data to estimate the number of Australians with a mental disorder in any year; a combination of administrative data on people receiving mental health care for the Commonwealth, States and Territories; and epidemiological data to estimate the number receiving treatment. They also used uncertainty modelling to allow for sampling error and assumptions on the estimates used.

The Australian Psychological Society welcomed the study, saying that as well as improving access to psychological treatment, the Medicare rebate had contributed to a significant destigmatisation of seeking help for mental health problems.

“The availability of Medicare rebates for psychological treatment in private settings via GP referral has clearly resulted in many individuals using these services where previously they would not have done so,” said APS executive director Professor Lyn Littlefield.

“The inclusion of mental health psychology services under the nation’s funded health system has begun to promote interventions for mental health to a similar standing to physical health services funded under Medicare, which is an extremely important development.”

Professor Littlefield noted however, that the study shows that 54 per cent of people with mental disorders are still not accessing treatment and she warned against any further government cuts in the mental health area.

“We have already begun to see an erosion of the effectiveness of Better Access since funding cuts came into effect last year,” she said.

“We need to protect the remarkable gains that have been made in treatment rates for mental illness since the Better Access initiative was introduced, and ensure the appropriate level of funding to provide these direct psychological services to people in need.”

Debra Vermeer