Australia’s Mental Health System Isn’t Just Failing Patients, It’s Failing Workers Too

“The system is failing our disadvantaged kids. It is not working, but we can fix it.”

These are the words of Marcus*, an Occupational Therapist who specialises in youth mental health. Marcus is in his late 20s and works on the frontline of our mental health services, looking after some of the most vulnerable young Australians. This is more than just a job for Marcus, it’s his passion.

But the truth is, our mental health system isn’t just failing our patients, it’s also becoming an unattractive profession for its workers. And while a lot of politicians have been talking about the impact of COVID-19 and numerous lockdowns on the mental health of young Australians, what we really need to be talking about is the fact that our mental health system was failing them long before COVID came along.

But the good news is there are ways we can fix this.

To make meaningful change, we need to make high quality mental health care available to more people, especially people who can’t afford to pay. And we need to support the mental health workforce with better pay through Medicare.

So, What Are The Problems In Our System?

When we think about Medicare-funded mental health services, many of us are aware of the 10 sessions a year a person can access from a psychologist or therapist, once they complete a mental health care plan with their GP. However, while the Federal Government recently increased the cap of sessions to 20, this doesn’t address the systemic issues we’re still facing.

This system is designed to help people going through temporary or periodic mental health challenges — things like anxiety issues, relationship breakdowns, or coping with grief. But if you are in, or on the verge of, a serious mental health crisis, the leading mental health researchers say that 20 Medicare-funded counselling sessions isn’t the right kind of treatment.

You require a more comprehensive model of mental health care involving medical oversight, rapid access to a skilled multidisciplinary team, support available for your carers, perhaps targeted case management, return to work assistance, or an integrated drug and alcohol abuse treatment to get you back on your feet. And, as a recent Productivity Commission report tells us, far too many people miss out on the specialist mental health support they need.

To meet the threshold for specialist services, a person must have attempted a highly lethal suicide or be classified as imminently suicidal.  Put simply: The fact that a person has to be on the brink of suicide to receive the full support from the Government is driving people to that brink — and it’s denying them the care they need to prevent them from getting there.

Then there are the socioeconomic disadvantages — a typical out-of-pocket payment for a clinical psychologist usually exceeds $100 per session. This leaves those who need help most struggling to afford treatment, stuck on months-long waiting lists for the overburdened bulk-billing system.

Like All Healthcare Issues, Early Intervention Is Key.

The longer a person is forced to sit and wait with mental health issues untreated, the more serious and chronic these issues can become — and, in the long run, the likelier they are to require hospitalisation and therefore costlier care.

To top it off, therapists working in the bulk-billing system struggle to make ends meet under the current system.

Take Federal Government-funded foundation headspace, for example. These clinics for young people are a fantastic initiative — but when Marcus worked as a bulk-billing private practitioner there, taking into account his costs, overheads, and the fact that he would receive nothing if a client no-showed, his actual pay worked out at around $27 an hour.

And there, he was dealing with many clients who needed more serious care than headspace could provide, but couldn’t afford or qualify for it.

At the moment, our system is funnelling practitioners into the private mental health sector because they cannot make a living in the public sector, creating an unfair disadvantage to those who cannot afford to pay.

What’s heartbreaking is that Marcus, like many allied mental health professionals, is passionate and trained to help people, but he is stuck waiting for the redesign of a system that is allowing people, especially young people, to die unnecessarily, leaving our communities at a loss.

So, What Needs To Change?

Firstly, we must address the workforce shortage. That means increasing Medicare rates in the bulk-billing system will mean workers earn what they deserve – and need — which will better incentivise skilled clinicians to practice there. By increasing the workforce, this will also shorten the times at-risk clients are forced to wait.

Secondly, bridge the gap between the Medicare ’10 sessions’ system and the more serious state funded clinical care programs. Make it so that people who clearly need more support and care are able to easily and quickly access it — offering them a quicker and easier recovery and lessening the burden on the system.

580 Victorians have died by suicide so far this year — but the scary thing is, this is even slightly lower than 600 at the end of October last year.

We need to do so much better by those who are suffering from mental illness and ill-health.

We should start by heeding the reports that have already been handed down and those to come — and implement their recommendations as quickly as possible.

The experts have been knocking on this door, it’s time for the Government to seriously listen.

*Name changed for privacy reasons.

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Josh Burns is Labor’s Federal MP for Macnamara, previously the seat of Melbourne Ports, first elected at the 2019 Federal Election.