Social Workers and Occupational Therapists Shut out of Medicare

By Allen-Kelly, Kandie; Charikar, Karl | Impact, Autumn 2010 | Go to article overview

Social Workers and Occupational Therapists Shut out of Medicare


Allen-Kelly, Kandie, Charikar, Karl, Impact


The proposal to remove social workers and occupational therapists from the Better Access initiative will reduce treatment options for people with mental health conditions, particularly those on low incomes and those in rural and regional Australia.

In this year's Federal Budget the Government announced that it would remove social workers and occupational therapists from the Better Access to Mental Health Care program (Better Access). No reason has been provided for this decision, which will remove 1,500 skilled mental health professionals from the Medicare subsidised program. Following a large public campaign after the Budget, the Government agreed to put any changes back until April 2011, to allow time for consultation, but so far the decision has not been changed. Many Australians who are unable to afford or unable to access an alternative service provider will not receive support for their diagnosed mental health disorder, while skilled professionals who have spent many years becoming specialists will be unable to provide services.

Background

Since 2006 the Better Access to Mental Health Care Initiative (usually shortened to Better Access) has provided people who have a diagnosed mental health issue with a Medicare rebate for allied health professional services, on referral from a GP. Rebates are available for a limited number of services from professionals including clinical and general psychologists, mental health accredited social workers and occupational therapists. They work in a wide range of settings including hospitals, community mental health services, drug and alcohol services and increasingly in private practice.

In 2008 the Government commissioned a wide-ranging review of Better Access, due to report back later this year. The Government announced before the completion of the review that it would remove social workers' and occupational therapists' eligibility to practice under the program from 1 July 2010. This decision was taken with absolutely no consultation with the professionals concerned or their representative bodies: and it raised an outcry from people involved in mental health across Australia.

The campaign was coordinated by the AASW and substantial numbers of social workers contacted their MPs, local newspapers and talkback radio. ACOSS and many member organisations have also offered their support and we will call on you again if required in the coming months. As a result of the campaign, the Government announced a deferral of the measure until 1 April 2011, but has still failed to provide alternative services for many people who would see social workers. Clients of these services have diagnosed mental health disorders such as depression, anxiety or post-traumatic stress. These conditions are often exacerbated by other stress, such as unemployment, physical disability or personal events such as a partner with drug and alcohol issues, a child displaying behavioural issues at school.

Failure to receive affordable services from skilled professionals can often mean that a mental health disorder goes untreated and can then worsen. Over 65% of social work clients report that they would not be able to see another professional if they had to pay a higher fee. …

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