Let’s fill the gaps in Medicare ‘Better Access’, PACFA CEO tells rural health conference

3 August 2022

PACFA’s CEO has presented at the National Rural Health Conference on how expanding the Medicare Better Access policy to include counsellors and psychotherapists could help fill gaps in mental healthcare provision.

Ms de Wever presented on 3 August, 2022, Day 2 of the 3-day conference, on ‘Filling gaps in the ‘Better Access policy’: counsellors in regional areas’.

She told participants that in 2021 while demand for mental health services peaked through the Covid pandemic, counsellors and psychotherapists were under-utilised. Meanwhile, as the media widely reported, there were long waiting lists for psychologists and psychiatrists.

In October and November 2020, a survey of 959 counsellors and psychotherapists found 27% wanted to work more hours and could support clients with mental health challenges, Ms de Wever told the conference. Accredited members of the profession could also provide evidence-based talk therapies for serious mental health issues such as trauma and eating disorders.

The study documenting the survey results, A snapshot of the counselling and psychotherapy workforce in Australia in 2020: Underutilised and poorly remunerated, yet highly qualified and desperately neededis published in the Psychotherapy and Counselling Journal of Australia.

The fact that counsellors and psychotherapists were ineligible for Medicare rebates under the Better Access initiative – unlike psychologists and psychiatrists – was one possible reason for the under-employment of some counsellors and psychotherapists, the study said.

With rural Australians at a disadvantage in accessing mental health services, Ms de Wever pointed to the survey’s findings that over 30% of practitioners were based in rural or remote areas, compared with psychologists (16.8 per cent) and psychiatrists (15.6 per cent).

PACFA member, Registered Clinical Counsellor Peter Kadwell’s story illustrates the benefits for regional and rural Australians of greater recognition of counsellors and psychotherapists as a mental health workforce.

In 2021, Peter (pictured) moved from Sydney back to his hometown of Crookwell, NSW, 240 kilometres south of Sydney and 112 kilometres north of Canberra, to care for his ailing mother.

Peter, who is also a member of PACFA’s Australian College of Relationship Counsellors Leadership Group, is the town’s only mental health professional, with a thriving private practice run within a medical practice.

If it were not for Peter, clients wanting face-to-face therapy would have to travel to Goulburn 41 kilometres away, or Canberra. Peter also provides online counselling to Relationships Australia NSW clients.

GPs within the town refer patients to Peter for therapy but his status as a counsellor means he cannot offer Medicare rebates.

‘Medicare rebates would be very helpful to make it affordable (for clients) because it’s a low socio-economic area,’ Peter said. While Peter offers a sliding scale of fees to improve accessibility, Medicare rebates would also support the sustainability of his practice.

Peter was the head of Calvary Hospital’s Department of Bereavement Counselling for 10 years prior to moving to Crookwell.