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ARCAP response to Mental Health Reference Group report

PACFA has made a submission with the ACA under the banner of the Australian Register of Counsellors and Psychotherapists (ARCAP) to demonstrate a cohesive response from the counselling and psychotherapy profession to the recent report form the Mental Health Reference Group (MHRG).

The MHRG, which is part of the Medicare Benefits Schedule Review, is looking at ways to improve the Better Access Initiative (BAI) which delivers primary care counselling services. Currently counsellors and psychotherapists are excluded as providers under BAI.

The MHRG report includes recommendations that represent an excellent opportunity for PACFA to advocate for counsellors and psychotherapists to become Medicare providers.

ARCAP’s response broadly supports the work done by MHRG and stresses that there is an opportunity to improve access to mental health services and improve client choice whilst increasing the overall mental health and wellbeing of the community.

The core message of our feedback is that counsellors and psychotherapists present as a highly-skilled, high value, but under-utilised workforce. We argue that counsellors and psychotherapists can meet workforce shortages and gaps meet the needs of under-serviced groups such as aged persons, people in rural and remote settings, Aboriginal and Torres Strait Islander peoples, newly settled migrants and refugees, families and carers, and in doing so improve equity of access to health services in the community.

Overview of the ARCAP submission

Some of the key recommendation covered in the ARCAP submission are:

  • Recommendation 1 – Expand the Better Access Program to at-risk patients;
  • Recommendation 3 – Introduce a 3-tiered system for access to Better Access sessions for patients with a diagnosed mental illness;
  • Recommendation 4 – Establish a new working group or committee to review access to, and rebates for, Better Access sessions delivered by different professional groups;

For recommendation 1, the crux of ARCAP’s position is that expanding services to people who are at-risk of developing mental illness would put added pressure on existing service providers and necessitate the inclusion of additional professional groups that cannot currently provide services under BAI. Additionally, a new patient cohort will be created which will require a review of referral and treatment processes. ARCAP argues that if an at-risk patient does not require a diagnosis, then a mental health plan is unnecessary.

The MHRG report recommends an introduction of a 3-tiered system for access to BAI in recommendation 3. ARCAP supports this recommendation and we add that a bulk of the demand for mental health services is at the level of early intervention and primary care services. A stepped care model, which includes registered counsellors and psychotherapists as providers under BAI, would enable better targeting of patient needs with suitable providers. Matching patient needs would also result in optimal use of workforce potential and bolster mental health workforce teams, and would allow specialist mental health treatment for those with severe mental health illness to be delivered by a range of specialist mental health providers.

ARCAP’s feedback for recommendation 4 is that rising demands in the population for mental health services, and the demands on the workforce, necessitate the establishment of a new working group or committee to seek a consensus amongst the professional groups on access to, and rebates for, BAI sessions.

It is very important that counsellors and psychotherapists are part of this new working group and that the group should not be dominated by any one profession. This will ensure decisions on the future workforce for BAI are balanced and in the interest of greater consumer choice. Patients may prefer to choose registered counsellors and psychotherapists because of the relational expertise, training, and scope of practice that more closely match their needs.

The ARCAP submission notes that there is an opportunity to meet the needs of sectors of the community that have been under-serviced or unable to access services by including counsellors and psychotherapists in BAI. By expanding BAI to utilise the full range of available professions, groups such as family and carers of people with mental illness, aged persons, people in rural and remote settings, Aboriginal and Torres Strait Islander peoples, newly settled migrants, and refugees, will stand to benefit.