Final Report Attachment 1: Background documents and tools · Department of Health and Ageing...

Department of Health and Ageing

Evaluation of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule

(Better Access) Initiative

Component D: Consultation with Stakeholders

Final Report Attachment 1: Background documents and tools

June 2010


Evaluation of the Better Access InitiativeAttachment 1: Background documents and tools

June 2010

Component D - June 2010- Report Appendices - revision 2906 (9278415) i

Contents

Glossary ii

1 Introduction 1

2 Interpreting the survey data 2

3 Survey of allied health professionals 3 3.1 Sampling 3 3.2 Responses to AHP survey 3 3.3 Comments from allied health provider survey 40 3.3.1 Profile of allied health respondents providing comment 40 3.3.2 Comments received on survey 41

4 Survey of GPs and psychiatrists 59 4.1 Sampling 59 4.2 Responses to survey of GPs and psychiatrists 59 4.3 Comments from survey of GPs and psychiatrists 91 4.3.1 Profile of GP respondents providing comment 91 4.3.2 Comments received on survey 91

5 Survey of public providers 100 5.1 Sampling 100 5.2 Responses to survey of public providers 100 5.3 Comments from survey of public providers 119 5.3.1 Profile of public provider respondents providing comment 119 5.3.2 Comments received on survey 119

6 Survey of NGOs 130 6.1 Sampling 130 6.2 Comments from survey of NGO providers 149 6.2.1 Profile of NGO respondents providing comment 149 6.2.2 Comments received on survey 149

7 Survey of consumers 151 7.1 Sampling 151 7.2 Responses to survey of consumers 151 7.3 Comments from survey of consumers 159

8 Survey of carers 167 8.1 Sampling 167 8.2 Responses to survey of carers 167 8.3 Comments from survey of carers 170


Evaluation of the Better Access InitiativeAttachment 1: Background documents and tools

June 2010

Glossary AASW Australian Association of Social Workers ACAT Aged Care Assessment Team ACCP Australian College of Clinical Psychologists ACMHN Australian College of Mental Health Nurses AGPN Australian General Practice Network AHP Allied Health Providers comprising occupational therapists,

psychologists and social workers approved to provide focussed psychological strategies through the Better Access initiative

AIHW Australian Institute of Health and Welfare APS Australian Psychological Society ATAPS Access to Allied Psychological Services BUPA BUPA Australia (owner of MBF) CALD Cultural and Linguistically Diverse Communities CAMHS Child and Adolescent Mental Health Services CBT Cognitive behaviour therapy CPD Continuing Professional Development CPE Continuing Professional Education Divisions Divisions of General Practice DOHA Department of Health and Ageing DVA Department of Veteran’s Affairs EPC Enhanced Primary Care program FPS Focussed psychological strategies GP(s) General Practitioner(s) HACC Home and Community Care Program HBA HBA health insurance HCF HCF health insurance fund MAHS More Allied Health Services Program MBF MBF health insurance fund MBS Medicare Benefits Schedule Medibank Medibank Private health insurance fund MHPA Mental Health Professional Association MHPN Mental Health Professional Network NET Narrative Exposure Therapy NGO(s) Non government organisation(s) OATSIH Office for Aboriginal and Torres Strait Islander Health OTA Occupational Therapy Australia PHAMs Personal Helpers and Mentors program RACGP Royal Australian College of General Practitioners RACP Royal Australasian College of Physicians RANZCP Royal Australian and New Zealand College of Psychiatrists TIS Translating and Interpreting Service VoIP Voice over Internet Protocol

Component D - June 2010- Report Appendices - revision 2906 (9278415) ii


Evaluation of the Better Access Initiative Attachment 1: Background documents and tools

April 2010

1 Introduction The Department of Health and Ageing (DoHA) engaged a number of external consultants to assist with the Evaluation of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) initiative. The evaluation was undertaken to assess the accessibility, appropriateness and effectiveness of primary mental health care provided to people with diagnosed mental health disorders under the Better Access initiative.

KPMG was contracted to undertake Component D of the evaluation – Stakeholder Consultation. Component D involved the design and establishment, collection and reporting of information from a range of stakeholders, including peak professional organisations and consumer and carer organisations with an interest in the Better Access initiative.

During the engagement period, more than 1200 people (representing themselves or a particular group or organisation) were consulted. These included:

• interviews (face to face or teleconference) of more than 100 people

• group teleconferences of approximately 60 people

• workshops of more than 40 people

• online surveys, completed by in excess of 1000 people.

This document summarises the responses to the following online surveys:

• Survey of allied health professionals

• Survey of GPs, psychiatrists and paediatricians

• Survey of public mental health providers

• Survey of non-government mental health service providers

• Survey of consumers

• Survey of carers.

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April 2010

2 Interpreting the survey data Responses are presented sequentially in the order in which the question was asked.

The survey question is provided, followed by a brief description of the response and a table providing the number and corresponding percentage of responses for each response option.

The number of missing responses varied across questions and is reported in relation to each question. Completeness of questions was generally high for descriptors of practice, clients and perceptions on improvements in access to services as a result of the Better Access initiative. It is noted that between 23 and 24 per cent of respondents to the Survey of allied health professionals and between 13 and 14 per cent of respondents to the Survey of GPs and psychiatrists did not answer questions regarding appropriateness of care or outcomes of services provided to different target populations (questions 41 onwards). It is likely that this was a result of respondents failing to differentiate from the preceding questions in relation to improvements in access to services by the same population groups.

Responses to free text questions are provided at the conclusion of each survey. For some respondents, some of the answers to questions allowing free text entry were incomplete or the content was unclear. This is indicated in the reporting of individual responses.

Postcode data reported is not provided, but summarised to provide an overview of responses by state and metropolitan, regional, rural and remote areas based on Australian Bureau of Statistics concordance tables1.

Where tests of significance are reported on likert type questions, these have been undertaken using chi-square tests. Data is aggregated to provide more robust cell sizes as follows:

• Agree = Strongly agree/ Agree

• Unsure = Unsure

• Disagree = Disagree/Strongly disagree

• No response/missing values excluded.

Note: Due to rounding, percentages provided in the tables may not total 100%.

1 ABS postcode concordance table




April 2010

3 Survey of allied health professionals

3.1 Sampling Information on the evaluation and hyperlink to the online survey was forwarded by email to the state branches of the AASW, APS and OTA for forwarding to their members. Links were also provided to sub groups of these organisations who had participated in the preceding consultations and indicated an interest in ensuring information was distributed to members.

The survey was live for a three-week period. A total of 420 allied health providers (AHPs) responded to this survey.

3.2 Responses to AHP survey Location of practice

Sixty two per cent of respondents provided postcode of principal practice. For the respondents for which location was known, 26 per cent were located in Victoria, 24 per cent in Western Australia, 20 per cent in NSW and 17 per cent were located in Queensland. Ninety three per cent of respondents were located in either a major city (74 per cent) or inner regional area (19 per cent). Seven per cent of respondents were located in outer regional areas and only one per cent (2 respondents) in remote areas.

State Major City Inner

Regional Outer

Regional Remote Missing Total State

State valid per cent

VIC 55 12 1 68 26% WA 51 5 5 1 62 24% NSW 36 15 2 53 20% QLD 31 9 5 45 17% SA 17 1 18 7% TAS 8 1 9 3% ACT 3 3 1% NT 2 1 3 1% Missing 159 159 Total region 193 49 17 2 159 420 Region valid per cent 74% 19% 7% 1%




April 2010

Q1. What is your occupation?

Only one occupational therapist responded to the online survey and two respondents did not provide their occupation.

Sixty three percent of total responses were from psychologists, with approximately equal numbers from clinical psychologists and general psychologists. Social workers comprised 35 per cent of total responses.

Occupation Respondents Per cent Clinical Psychologist 131 31% Occupational Therapist 1 0% Psychologist 133 32% Social Worker 153 36% (blank) 2 0% Grand Total 420 100%

Q2. Has the Better Access initiative affected access to clinical training in your discipline?

Most respondents (64 per cent) reported that they did not think the Better Access Initiative had improved access to clinical training. Only one third of respondents believed that clinical training had been affected.

Affected access to clinical training Respondents Per cent No 268 64% Yes 143 34% (blank) 9 2% Grand Total 420 100%

Q2a. Has the Better Access initiative affected access to clinical training in your discipline? If yes, has it improved access or made it more difficult?

Of those respondents who believed that clinical training had been affected, 67 per cent reported that it had improved access while 27 per cent reported that it had made access more difficult.

Impact on access to clinical training Respondents Per cent Improved access 96 67% Made it more difficult 38 27% (blank) 9 6% Grand Total 143 100%




April 2010

Q3. Do you work in a private practice or in both private and public practice?

Approximately two thirds of the respondents worked in private practice only, with about one third working in both public and private sectors.

Working in private and public practice Respondents Per cent Both public and private 139 33% Private 277 66% (blank) 4 1% Grand Total 420 100%

Q4. How long have you been in private practice?

Approximately half (49 per cent) of respondents had been in private practice six or more years. Those with less experience in private practice (five years or less) were more likely to work in both public and private sectors (60 per cent of respondents work in public and private practice) than in the private sector alone (44 per cent of respondents work in only the private sector).

Private practice Both public and private All respondents Time in private practice Respondents Per

cent Respondents Per cent Respondents Per

cent Less than 2 years 43 16% 42 30% 85 20%

2 to 5 years 77 28% 42 30% 119 29%

6 to 10 years 51 18% 18 13% 69 17%

11 to 20 years 69 25% 25 18% 94 23%

21 years and over 31 11% 6 4% 37 9%

(blank) 6 2% 6 4% 12 3%

Total 277 100% 139 100% 416 100%

Q5. On average, how many hours per week do you work in private practice?

Approximately one third of respondents reported working 15 hours or less per week and one third reported working between 15 and 30 hours per week in private practice. Twenty two per cent of respondents reported working 31-45 hours per week and seven per cent worked more than 46 hours per week in private practice.

Of the respondents who worked in both public and private sectors, the majority (62 per cent) worked 15 hours or less per week in private practice, while 27 per cent worked 16-30 hours per week. Of those who worked in private practice only, the spread was somewhat more even, with 19 per cent working 15 hours or less, 37 per cent working 16-30 hours per week and 30 per cent working 31-45 hours per week.




April 2010

Private practice Both public and private All respondents

Hours worked per week Respondents Per


cent 1 to 15 hours per week 53 19% 86 62% 139 33% 16 to 30 hours per week 103 37% 37 27% 140 34% 31 to 45 hours per week 84 30% 8 6% 92 22% 46 + hours per week 30 11% 1 1% 31 7% (blank) 7 3% 7 5% 14 3% Grand Total 277 100% 139 100% 416 100%

Q6. Since 1 January 2009, how many clients have been referred to you by GPs/ Psychiatrists/Paediatricians through the Better Access initiative?

Since 1 January 2009, nearly half (44 per cent) of respondents reported 20 or fewer patients referred to them by GPs, psychiatrists or paediatricians through the Better Access Initiative and 50 per cent reported receiving 21 or more referrals.

Of those respondents working solely in private practice, 61 per cent reported receiving 21 or more referrals and 29 per cent reported receiving 51 or more referrals. Respondents working in public and private practice received fewer referrals, with 29 per cent reporting that they received 21 or more referrals and only six per cent reporting that they received 51 or more referrals.

Private practice Both public and private All respondents Number of referrals since January 2009 Respondents

Per cent Respondents


Per cent

1 to 10 patients 37 13% 45 32% 82 20% 11 to 20 patients 58 21% 43 31% 101 24% 21 to 50 patients 90 32% 32 23% 122 29% 51 to 100 patients 58 21% 9 6% 67 16% 101 + patients 22 8% 22 5% (blank) 12 4% 10 7% 22 5% Total 277 100% 139 100% 416 100%

An examination of referrals by provider type found that clinical psychologists received 30 per cent more referrals from GPs than did psychologists and 60 per cent more than social workers.

Q7. Since 1 January 2009, please estimate the average waiting time for patients to see you who have been referred to you by GPs/Psychiatrists/Paediatricians through the Better Access initiative?

Overall, 73 per cent of respondents reported an average waiting time of 14 days or less. Respondents working in both public and private practice reported shorter waiting times than respondents working solely in private practice. Fifty per cent of respondents in public and private practice reported waiting times of seven days or less, and 79 per cent reported waiting times of 14 days or less.




April 2010

Practitioners working in private practice reported slightly longer waiting times for clients referred through the Better Access Initiative, with only 33 per cent of practitioners having waiting times of seven days or less and 71 per cent reported waiting times of 14 days or less. Eighteen per cent reported waiting times of 15-28 days and six per cent with waiting times in excess of 29 days.


Average waiting time Respondents Per cent Respondents


Per cent

7 days or less 91 33% 69 50% 160 38% 8 to 14 days 106 38% 41 29% 147 35% 15 to 28 days 49 18% 15 11% 64 15% 29 to 42 days 15 5% 4 3% 19 5% More than 42 days 3 1% 3 1% (blank) 13 5% 10 7% 23 6% Total 277 100% 139 100% 416 100%

Q8. Since 1 January 2009, on average how would you rate the information provided to you in the GP Mental Health Care Plan from the referring GP?

Overall, the majority (73 per cent) of respondents reported the information provided in the GP Mental Health Care Plan as good (33 per cent) or fair (40 per cent). Five per cent rated the information provided as very good, while twenty seven per cent rated the information provided as poor (13 per cent) or very poor (four per cent).

There were only slight differences in the views held by respondents working solely in private practice and those working in both public and private practice.

Private practice Both public and private All respondents Quality of

information provided in GP care plan Respondents Per


cent Very Good 16 6% 4 3% 20 5% Good 90 32% 49 35% 139 33% Fair 116 42% 50 36% 166 40% Poor 32 12% 22 16% 54 13% Very poor 11 4% 4 3% 15 4% (blank) 12 4% 10 7% 22 5% Total 277 100% 139 100% 416 100%




April 2010

Q9. Since 1 January 2009, have you had clients referred to you through the Better Access Initiative that were not appropriate referrals?

The majority (72 per cent) of respondents reported that they had not received inappropriate referrals. There was very little difference between the perceptions of respondents working solely in private practice and those working in both public and private practice.

Twenty two per cent of respondents reported receiving referrals through the Better Access Initiative that were not appropriate, and seven percent reported that they were unsure whether they had received referrals that were not appropriate.

Private practice Both public and private All respondents Received inappropriate referrals Respondents Per


cent No 200 72% 101 73% 301 72% Yes 61 22% 26 19% 87 21% (blank) 16 6% 12 9% 28 7% Total 277 100% 139 100% 416 100%

Q9a. Since 1 January 2009, what percentage of the clients referred to you were not appropriate referrals?

Of those practitioners who reported receiving referrals that were not appropriate, 74% of respondents reported that these comprised five per cent or less than the total clients referred. A small number of respondents (six respondents, or 1.5 per cent of all respondents to the survey) reported that 20 per cent or more referrals were not appropriate.

There were only small differences in the perceptions reported by respondents working solely in private practice and those working in both public and private practice.

Private practice Both public and private All respondents Referrals that were not appropriate Respondents Per


cent 5% or less 46 75% 18 69% 64 74% Between 6 to 20% 11 18% 6 23% 17 19% Greater than 20% 4 7% 2 8% 6 7% Total 61 100% 26 100% 87 100%




April 2010

Q9b. What was the main reason these referrals were not appropriate?

Of those who reported inappropriate referrals, the most common reason (38 per cent) was that the referrals were not for a disorder eligible for treatment through the Better Access initiative. Smaller, more equal proportions of respondents reported that the referrals were inappropriate because they were not appropriate to the range of services they provided (18 per cent) or an equal combination of the disorder not being eligible and the referral not being appropriate to their particular range of services (23 per cent).

Of those practitioners who reported receiving referrals that were not appropriate, 74% of respondents reported that these comprised five per cent or less than the total clients referred. A small number of respondents (six respondents, or 1.5 per cent of all respondents to the survey) reported that 20 per cent or more referrals were not appropriate. There was little difference in the perceptions reported by respondents working solely in private practice and those working in both public and private practice.


Reason for inappropriate referrals Respondents Per


cent Referrals did not have a disorder eligible for treatment through Better Access 24 39% 9 35% 33 38% Referrals were not appropriate to the range of services that I provide 13 21% 3 12% 16 18% Roughly equal combination of the above 13 21% 7 27% 20 23% Other 11 18% 7 27% 18 21% Total 61 100% 26 100% 87 100%


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April 2010

10

Q10. Of those patients referred to you through the Better Access initiative since 1 January 2009, please estimate the percentage who are receiving treatment for their mental disorders for the first time?

Approximately half of respondents reported that more than 61 per cent of referrals were receiving treatment for their mental disorder for the first time, and 18 per cent reported that more than 81 per cent of their referrals were receiving treatment for the first time.

There was little difference in the perceptions reported by respondents working solely in private practice and those working in both public and private practice.

Private practice Both public and private All respondents Referrals receiving treatment for first time Respondents Per


cent 0 to 20 % 21 8% 17 12% 38 9% 21 to 40% 31 11% 18 13% 49 12% 41to 60% 70 25% 29 21% 99 24% 61 to 80% 92 33% 38 27% 130 31% 81 to 100% 47 17% 27 19% 74 18% (blank) 16 6% 10 7% 26 6% Total 277 100% 139 100% 416 100%

Q11. Of those patients referred to you through the Better Access initiative since 1 January 2009, please estimate the percentage who are receiving treatment for their mental disorders who are from culturally or linguistically diverse backgrounds?

Seventy per cent of respondents reported that fewer than 20 per cent of their clients referred through the Better Access initiative were from culturally or linguistically diverse backgrounds. A smaller proportion (17 per cent) reported between 21 and 40 per cent were from culturally or linguistically diverse backgrounds and eight per cent reported that more than 40 per cent of referrals were from culturally or linguistically diverse backgrounds. There was little difference in the perceptions reported by respondents working solely in private practice and those working in both public and private practice.

Private practice Both public and private All respondents Referrals from culturally and linguistically diverse background

Respondents Per cent Respondents Per cent Respondents Per cent

0 to 20 % 199 72% 92 66% 291 70% 21to 40% 44 16% 26 19% 70 17% 41 to 60% 10 4% 7 5% 17 4% 61 to 80% 6 2% 2 1% 8 2% 81 to 100% 5 2% 3 2% 8 2% (blank) 13 5% 9 6% 22 5% Grand Total 277 100% 139 100% 416 100%



April 2010

Q 27. To what extent do you agree with the following statement: the Better Access initiative has contributed to mental health services becoming more affordable.

Ninety-two per cent of respondents strongly agreed with the statement that the Better Access Initiative has contributed to mental health services becoming more affordable. Four percent of respondents disagreed with this statement. Three per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to services being more affordable Respondents Per cent Strongly Agree 317 75% Agree 70 17% Unsure 12 3% Disagree 7 2% Strongly Disagree 7 2% Did not respond 7 2% Grand Total 420 100%

Though social workers were less likely to report strong agreement with the statement of improved affordability, there was no significant difference2 across occupational groups in respect to overall agreement. 3

OccupationNumber Per cent Number Per cent Number Per cent Number Per cent Number Per cent Number Per cent Number Per cent

Clinical Psychologist 110 84% 15 11% 2 2% 0% 3 2% 1 1% 131 100%Psychologist 114 86% 14 11% 1 1% 1 1% 2 2% 1 1% 133 100%Social Worker 93 61% 41 27% 9 6% 6 4% 2 1% 2 1% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 317 76% 70 17% 12 3% 7 2% 7 2% 5 1% 418 100%

To what extent do you agree with the following statement: Better Access has contributed to mental health services becoming more affordable Strongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree

2 Chi-squared 8.56, Degrees of freedom = 4, P= 0.07. 3 Two respondents did not provide an occupation, resulting in total responses by occupation (418 responses) being less than the overall total of 420

responses. Component D - June 2010- Report Appendices - revision 2906 (9278415) 11



April 2010

Q 28. To what extent do you agree with the following statement: the Better Access initiative has contributed to more allied health professionals (clinical psychologists, occupational therapists, psychologists and social workers) providing mental health services in the community.

Eighty eight per cent of respondents reported that they agreed with the statement that the Better Access Initiative has contributed to more allied health professional providing mental health services in the community. Two percent disagreed with this statement. Eight percent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to more allied health services in the community Respondents Per cent Strongly Agree 242 58% Agree 127 30% Unsure 34 8% Disagree 4 1% Strongly Disagree 5 1% Did not respond 8 2% Grand Total 420 100%

Though relatively fewer social workers reported agreement with the statement of the Better Access Initiative contributing to more allied health professionals providing mental health services in the community, the difference was not significant4.


Clinical Psychologist 78 60% 41 31% 8 6% 1 1% 2 2% 1 1% 131 100%Psychologist 85 64% 37 28% 7 5% 2 2% 1 1% 1 1% 133 100%Social Worker 79 52% 49 32% 19 12% 1 1% 2 1% 3 2% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 242 58% 127 30% 34 8% 4 1% 5 1% 6 1% 418 100%

To what extent do you agree with the following statement: Better Access has contributed to more allied health professionals (clinical psychologists, occupational therapists, psychologists and social workers) providing mental health services in the community

Strongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree

4 Chi-squared 6.10, Degrees of freedom = 4, P= 0.19 Component D - June 2010- Report Appendices - revision 2906 (9278415) 12



April 2010

Q29. To what extent do you agree with the following statement: the Better Access initiative has contributed to more GPs providing mental health services.

Fifty one per cent of respondents reported that they agreed with the statement that the Better Access Initiative has contributed to more GPs providing mental health services. Eight per cent disagreed with this statement. Thirty seven per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to more GPs providing mental health services Respondents Per cent Strongly Agree 93 22% Agree 130 31% Unsure 155 37% Disagree 30 7% Strongly Disagree 6 1% Did not respond 6 1% Grand Total 420 100%

There was no significant difference5 in responses to this question between occupational groups.


Clinical Psychologist 22 17% 40 31% 51 39% 15 11% 3 2% 0% 131 100%Psychologist 37 28% 41 31% 42 32% 8 6% 3 2% 2 2% 133 100%Social Worker 34 22% 49 32% 62 41% 7 5% 0% 1 1% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 93 22% 130 31% 155 37% 30 7% 6 1% 4 1% 418 100%

To what extent do you agree with the following statement:Better Access has contributed to more GPs providing mental health services Strongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q30. To what extent do you agree with the following statement: the Better Access initiative has contributed to psychiatrists being more accessible.

Twenty five per cent of respondents agreed with the statement that the Better Access Initiative had contributed to psychiatrists being more accessible. Thirty three per cent disagreed with this statement. Fifty per cent per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to more psychiatrists being more accessible Respondents Per cent Strongly Agree 17 4% Agree 46 11% Unsure 210 50% Disagree 87 21% Strongly Disagree 50 12% Did not respond 10 2% Grand Total 420 100%




To what extent do you agree with the following statement:Better Access has contributed to psychiatrists being more accessibleStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q31. To what extent do you agree with the following statement: the Better Access initiative has contributed to more culturally and linguistically diverse mental health services.

Twenty five per cent of respondents agreed with the statement that the Better Access Initiative had contributed to more culturally and linguistically diverse mental health services. Fifteen per cent disagreed with this statement. Fifty eight per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to more culturally and linguistically diverse mental health services Respondents Per cent Strongly Agree 27 6% Agree 80 19% Unsure 244 58% Disagree 44 10% Strongly Disagree 19 5% Did not respond 6 1% Grand Total 420 100%



Clinical Psychologist 12 9% 24 18% 78 60% 13 10% 4 3% 0% 131 100%Psychologist 8 6% 29 22% 74 56% 15 11% 6 5% 1 1% 133 100%Social Worker 7 5% 27 18% 92 60% 16 10% 9 6% 2 1% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 27 6% 80 19% 244 58% 44 11% 19 5% 4 1% 418 100%

To what extent do you agree with the following statement:Better Access has contributed to more culturally and linguistically diverse mental health services Strongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q32. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People with anxiety or depression related disorders.

Ninety six per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making mental health services more accessible for people with anxiety or depression related disorders. One per cent disagreed with this statement. Two per cent of respondents reported that they were unsure.




Clinical Psychologist 105 80% 21 16% 2 2% 1 1% 2 2% 0% 131 100%Psychologist 107 80% 22 17% 2 2% 1 1% 1 1% 0% 133 100%Social Worker 102 67% 47 31% 4 3% 0% 0% 0% 153 100%Occupational Therapist 0% 0% 1 100% 0% 0% 0% 1 100%Total responses 314 75% 90 22% 9 2% 2 0% 3 1% 0% 418 100%

To what extent do you agree Better Access has contributed to making mental health services more accessible for people with anxiety or depression related disorders





April 2010

Q33. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People with substance use disorders.

Sixty one per cent of respondents agreed that Better Access had contributed to making health services more accessible for people with substance use disorders. Seven per cent disagreed with this statement. Thirty per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to services being more accessible for people with substance abuse disorders Respondents Per cent Strongly Agree 104 25% Agree 153 36% Unsure 126 30% Disagree 26 6% Strongly Disagree 4 1% Did not respond 7 2% Grand Total 420 100%



Clinical Psychologist 39 30% 49 37% 35 27% 5 4% 2 2% 1 1% 131 100%Psychologist 42 32% 46 35% 36 27% 6 5% 2 2% 1 1% 133 100%Social Worker 23 15% 58 38% 55 36% 15 10% 0% 2 1% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 104 25% 153 37% 126 30% 26 6% 4 1% 5 1% 418 100%

To what extent do you agree Better Access has contributed to making mental health services more accessible for people with substance use disordersStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 34. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: Aboriginal and Torres Strait Islander people.

Thirty per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for Aboriginal and Torres Strait Islander people. Fourteen per cent disagreed with this statement. Sixty five per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for Aboriginal and Torres Strait Islander people Respondents Per cent Strongly Agree 37 9% Agree 47 11% Unsure 272 65% Disagree 53 13% Strongly Disagree 6 1% Did not respond 5 1% Grand Total 420 100%

Though proportionally less social workers agreed that the Better Access Initiative had contributed to services being more accessible for Aboriginal and Torres Strait Islander people, the difference was not significant10.


Clinical Psychologist 15 11% 17 13% 87 66% 11 8% 1 1% 0% 131 100%Psychologist 16 12% 17 13% 81 61% 17 13% 0% 2 2% 133 100%Social Worker 6 4% 13 8% 104 68% 25 16% 5 3% 0% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 37 9% 47 11% 272 65% 53 13% 6 1% 3 1% 418 100%

To what extent do you agree Better Access has contributed to making mental health services more accessible for Aboriginal and Torres Strait Islander peopleStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 35. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People living in rural communities.

Thirty seven per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for people living in rural communities. Ten per cent disagreed with this statement. Fifty two per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for people living in rural communities Respondents Per cent Strongly Agree 67 16% Agree 88 21% Unsure 217 52% Disagree 32 8% Strongly Disagree 9 2% Did not respond 7 2% Grand Total 420 100%




To what extent do you agree Better Access has contributed to making mental health services more accessible for people living in rural communitiesStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 36. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People living in remote communities.

Fourteen per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for people living in remote communities. Fourteen per cent disagreed with this statement. Seventy per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for people living in remote communities Respondents Per cent Strongly Agree 30 7% Agree 31 7% Unsure 294 70% Disagree 39 9% Strongly Disagree 21 5% Did not respond 5 1% Grand Total 420 100%



Clinical Psychologist 10 8% 9 7% 91 69% 14 11% 7 5% 0% 131 100%Psychologist 10 8% 9 7% 96 72% 11 8% 6 5% 1 1% 133 100%Social Worker 10 7% 13 8% 107 70% 14 9% 8 5% 1 1% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 30 7% 31 7% 294 70% 39 9% 21 5% 3 1% 418 100%

To what extent do you agree Better Access has contributed to making mental health services more accessible for people living in remote communitiesStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 37. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People from culturally and linguistically diverse backgrounds.13

Thirty seven per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for people from culturally and linguistically diverse backgrounds. Eleven per cent disagreed. Fifty three per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for people from culturally and linguistically diverse backgrounds Respondents Per cent Strongly Agree 45 11% Agree 109 26% Unsure 223 53% Disagree 32 8% Strongly Disagree 7 2% Did not respond 4 1% Grand Total 420 100%



Clinical Psychologist 17 13% 32 24% 72 55% 9 7% 1 1% 0% 131 100%Psychologist 17 13% 39 29% 64 48% 11 8% 1 1% 1 1% 133 100%Social Worker 11 7% 38 25% 87 57% 12 8% 5 3% 0% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 45 11% 109 26% 223 53% 32 8% 7 2% 2 0% 418 100%

To what extent do you agree Better Access has contributed to making mental health services more accessible for people from culturally and linguistically diverse backgrounds


13 Note previous question 31 refers to Better Access Initiative contributing to more culturally and linguistically diverse mental health services 14 Chi-squared 3.06, Degrees of freedom = 4, P= 0.55 Component D - June 2010- Report Appendices - revision 2906 (9278415) 21



April 2010

Q 38. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: Children and young people.

Seventy two per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making mental health services more accessible for children and young people. Four per cent disagreed. Twenty three per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for children and young people Respondents Per cent Strongly Agree 138 33% Agree 164 39% Unsure 98 23% Disagree 12 3% Strongly Disagree 5 1% Did not respond 3 1% Grand Total 420 100%

Significantly fewer social workers15 agreed that the Better Access Initiative had contributed to services being more accessible for children and young people than other occupational groups.


Clinical Psychologist 57 44% 49 37% 22 17% 1 1% 2 2% 0% 131 100%Psychologist 48 36% 54 41% 25 19% 5 4% 1 1% 0% 133 100%Social Worker 33 22% 61 40% 51 33% 6 4% 2 1% 0% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 138 33% 164 39% 98 23% 12 3% 5 1% 1 0% 418 100%

To what extent do you agree Better Access has contributed to making mental health services more accessible for children and young peopleStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 39. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: Older people (i.e. those aged 65 + years).

Seventy one per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making mental health services more accessible for older people. Five per cent disagreed. Twenty three per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for older people Respondents Per cent Strongly Agree 140 33% Agree 160 38% Unsure 95 23% Disagree 13 3% Strongly Disagree 7 2% Did not respond 5 1% Grand Total 420 100%

Fewer social workers agreed that the Better Access Initiative had contributed to services being more accessible for older people than did other occupational groups. The difference was approaching significance16.


Clinical Psychologist 51 39% 45 34% 30 23% 2 2% 2 2% 1 1% 131 100%Psychologist 58 44% 49 37% 20 15% 5 4% 1 1% 0% 133 100%Social Worker 31 20% 66 43% 45 29% 6 4% 4 3% 1 1% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 140 33% 160 38% 95 23% 13 3% 7 2% 3 1% 418 100%

To what extent do you agree Better Access has contributed to making mental health services more accessible for older people (i.e. those aged 65 + years)Strongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 40. Additional comments Feedback received through this question is included in the main body of the report and provided at the conclusion of this appendix.

Q 41. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People with anxiety or depression related disorders. Seventy five per cent of respondents agreed with the statement that the Better Access Initiative had contributed to more appropriate services being provided to people with anxiety or depression related disorders. Two per cent of respondents were unsure and 23 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people with anxiety or depression related disorders Respondents Per cent Strongly Agree 225 54% Agree 87 21% Unsure 8 2% Disagree 2 0% Strongly Disagree 1 0% Did not respond 97 23% Grand Total 420 100%



Clinical Psychologist 76 58% 25 19% 1 1% 0% 1 1% 28 21% 131 100%Psychologist 82 62% 16 12% 5 4% 2 2% 0% 28 21% 133 100%Social Worker 67 44% 46 30% 2 1% 0% 0% 38 25% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 225 54% 87 21% 8 2% 2 0% 1 0% 95 23% 418 100%

To what extent do you agree Better Access has contributed to more appropriate services being provided to people with anxiety or depression related disordersStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 42. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People with substance use disorders.

Forty four per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people with substance abuse disorders. Three per cent disagreed with this statement. Twenty nine per cent per cent of respondents unsure and 24 four per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people substance abuse disorders Respondents Per cent Strongly Agree 77 18% Agree 109 26% Unsure 123 29% Disagree 11 3% Strongly Disagree 1 0% Did not respond 99 24% Grand Total 420 100%



Clinical Psychologist 25 19% 32 24% 42 32% 2 2% 1 1% 29 22% 131 100%Psychologist 29 22% 38 29% 31 23% 6 5% 0% 29 22% 133 100%Social Worker 23 15% 39 25% 50 33% 3 2% 0% 38 25% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 77 18% 109 26% 123 29% 11 3% 1 0% 97 23% 418 100%

To what extent do you agree Better Access has contributed to more appropriate services being provided to people with substance use disordersStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 43. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: Aboriginal and Torres Strait Islander people.

Thirteen per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to Aboriginal and Torres Strait Islander people. Four per cent disagreed with this statement. Sixty per cent of respondents were unsure and 24 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to Aboriginal and Torres Strait Islander people Respondents Per cent Strongly Agree 16 4% Agree 38 9% Unsure 250 60% Disagree 15 4% Strongly Disagree 2 0% Did not respond 99 24% Grand Total 420 100%



Clinical Psychologist 7 5% 15 11% 78 60% 2 2% 0% 29 22% 131 100%Psychologist 6 5% 15 11% 78 59% 5 4% 0% 29 22% 133 100%Social Worker 3 2% 8 5% 94 61% 8 5% 2 1% 38 25% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 16 4% 38 9% 250 60% 15 4% 2 0% 97 23% 418 100%

To what extent do you agree Better Access has contributed to more appropriate services being provided to Aboriginal and Torres Strait Islander peopleStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 44. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People living in rural communities.

Twenty six per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people living in rural communities. Four per cent disagreed with this statement. Forty seven per cent of respondents were unsure and 25 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people living in rural communities Number Per cent Strongly Agree 49 12% Agree 57 14% Unsure 196 47% Disagree 11 3% Strongly Disagree 4 1% Did not respond 103 25% Grand Total 420 100%



Clinical Psychologist 17 13% 18 14% 61 47% 5 4% 0% 30 23% 131 100%Psychologist 18 14% 14 11% 65 49% 2 2% 3 2% 31 23% 133 100%Social Worker 14 9% 25 16% 70 46% 4 3% 1 1% 39 25% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 49 12% 57 14% 196 47% 11 3% 4 1% 101 24% 418 100%

To what extent do you agree Better Access has contributed to more appropriate services being provided to people living in rural communitiesStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 45. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People living in remote communities.

Fourteen per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people living in remote communities. Four per cent disagreed with this statement. Fifty seven per cent of respondents were unsure and 25 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people living in rural communities Respondents Per cent Strongly Agree 23 5% Agree 37 9% Unsure 241 57% Disagree 12 3% Strongly Disagree 4 1% Did not respond 103 25% Grand Total 420 100%




To what extent do you agree Better Access has contributed to more appropriate services being provided to people living in remote communitiesStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 46. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People from culturally and linguistically diverse backgrounds.

Twenty seven per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people from culturally and linguistically diverse backgrounds. Four per cent disagreed with this statement. Forty six per cent of respondents were unsure and 24 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people from culturally and linguistically diverse backgrounds Respondents Per cent Strongly Agree 32 8% Agree 78 19% Unsure 192 46% Disagree 15 4% Strongly Disagree 1 0% Did not respond 102 24% Grand Total 420 100%




To what extent do you agree Better Access has contributed to more appropriate services being provided to people from culturally and linguistically diverse backgrounds





April 2010

Q 47. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: Children and young people.

Fifty four per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to children and young people. One per cent disagreed with this statement. Twenty one per cent of respondents were unsure and 24 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to children and young people Respondents Per cent Strongly Agree 101 24% Agree 124 30% Unsure 89 21% Disagree 4 1% Did not respond 102 24% Grand Total 420 100%

Note no ‘strongly disagree’ responses

Fewer social workers agreed that the Better Access Initiative had contributed to more appropriate services for children and young people than did other occupational groups. The difference was approaching significance23.


Clinical Psychologist 39 30% 33 25% 30 23% 0% 0% 29 22% 131 100%Psychologist 40 30% 44 33% 19 14% 1 1% 0% 29 22% 133 100%Social Worker 22 14% 47 31% 40 26% 3 2% 0% 41 27% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 101 24% 124 30% 89 21% 4 1% 0% 100 24% 418 100%

To what extent do you agree Better Access has contributed to more appropriate services being provided to children and young peopleStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 48. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: Older people (i.e. those aged 65 + years).

Fifty three per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to older people. One per cent disagreed with this statement. Twenty two per cent of respondents were unsure and 24 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to older people Respondents Per cent Strongly Agree 101 24% Agree 121 29% Unsure 93 22% Disagree 4 1% Strongly Disagree 1 0% Did not respond 100 24% Grand Total 420 100%

Fewer social workers agreed that the Better Access Initiative had contributed to more appropriate services for older people than did other occupational groups. The difference was approaching significance24.


Clinical Psychologist 36 27% 34 26% 31 24% 0% 1 1% 29 22% 131 100%Psychologist 44 33% 39 29% 20 15% 1 1% 0% 29 22% 133 100%Social Worker 21 14% 48 31% 42 27% 3 2% 0% 39 25% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 101 24% 121 29% 93 22% 4 1% 1 0% 98 23% 418 100%

To what extent do you agree Better Access has contributed to more appropriate services being provided to older people (i.e. those aged 65 + years)Strongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 49. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People with anxiety or depression related disorders.

Seventy five per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people with anxiety or depression related disorders. Two respondents (less than one per cent) disagreed with this statement. Three per cent of respondents were unsure and 22 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people with anxiety or depression related disorders Respondents Per cent Strongly Agree 227 54% Agree 87 21% Unsure 11 3% Disagree 2 0% Strongly Disagree 2 0% Did not respond 91 22% Grand Total 420 100%



Clinical Psychologist 77 59% 24 18% 1 1% 0% 1 1% 28 21% 131 100%Psychologist 81 61% 16 12% 5 4% 2 2% 1 1% 28 21% 133 100%Social Worker 69 45% 47 31% 5 3% 0% 0% 32 21% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 227 54% 87 21% 11 3% 2 0% 2 0% 89 21% 418 100%

To what extent do you agree Better Access has contributed to improved mental health outcomes for people with anxiety or depression related disordersStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 50. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People with substance use disorders.

Forty six per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people with substance abuse disorders. Four per cent disagreed with this statement. Twenty eight per cent of respondents were unsure and 22 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people with substance abuse disorders Respondents Per cent Strongly Agree 74 18% Agree 117 28% Unsure 119 28% Disagree 16 4% Strongly Disagree 1 0% Did not respond 93 22% Grand Total 420 100%



Clinical Psychologist 31 24% 37 28% 32 24% 2 2% 1 1% 28 21% 131 100%Psychologist 27 20% 37 28% 37 28% 4 3% 0% 28 21% 133 100%Social Worker 16 10% 43 28% 50 33% 10 7% 0% 34 22% 153 100%Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1 100%Total responses 74 18% 117 28% 119 28% 16 4% 1 0% 91 22% 418 100%

To what extent do you agree Better Access has contributed to improved mental health outcomes for people with substance use disordersStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 51. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: Aboriginal and Torres Strait Islander people.

Fourteen per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for Aboriginal and Torres Strait Islander people. Seven per cent disagreed with this statement. Fifty seven per cent of respondents were unsure and 22 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for Aboriginal and Torres Strait Islander people Respondents Per cent Strongly Agree 23 5% Agree 37 9% Unsure 238 57% Disagree 24 6% Strongly Disagree 4 1% Did not respond 94 22% Grand Total 420 100%




To what extent do you agree Better Access has contributed to improved mental health outcomes for Aboriginal and Torres Strait Islander peopleStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 52. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People living in rural communities.

Twenty eight per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people living in rural communities. Six per cent of respondents disagreed with this statement. Forty four per cent of respondents were unsure and 22 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people living in rural communities. Respondents Per cent Strongly Agree 50 12% Agree 67 16% Unsure 183 44% Disagree 21 5% Strongly Disagree 5 1% Did not respond 94 22% Grand Total 420 100%




To what extent do you agree Better Access has contributed to improved mental health outcomes for people living in rural communitiesStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 53. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People living in remote communities.

Sixteen per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people living in remote communities. Six per cent of respondents disagreed with this statement. Fifty six per cent of respondents were unsure and 22 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people living in remote communities. Respondents Per cent Strongly Agree 24 6% Agree 40 10% Unsure 234 56% Disagree 23 5% Strongly Disagree 6 1% Did not respond 93 22% Grand Total 420 100%




To what extent do you agree Better Access has contributed to improved mental health outcomes for people living in remote communitiesStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 54. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People from culturally and linguistically diverse backgrounds.

Twenty five per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people from culturally and linguistically diverse backgrounds. Five per cent of respondents disagreed with this statement. Forty seven per cent were unsure and 22 two per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people from culturally and linguistically diverse backgrounds Respondents Per cent Strongly Agree 30 7% Agree 74 18% Unsure 199 47% Disagree 21 5% Strongly Disagree 2 0% Did not respond 94 22% Grand Total 420 100%




To what extent do you agree Better Access has contributed to improved mental health outcomes for people from culturally and linguistically diverse backgroundsStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree




April 2010

Q 55. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: Children and young people.

Fifty four per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for children and young people. Three per cent of respondents disagreed with this statement. Twenty per cent of respondents were unsure and 22 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for children and young people Respondents Per cent Strongly Agree 98 23% Agree 130 31% Unsure 86 20% Disagree 12 3% Strongly Disagree 2 0% Did not respond 92 22% Grand Total 420 100%

Fewer social workers agreed that the Better Access Initiative had contributed to more appropriate services for children and young people than did other occupational groups. The difference was not significant31.


Clinical Psychologist 37 28% 37 28% 27 21% 1 1% 1 1% 28 21% 131 100%Psychologist 36 27% 44 33% 18 14% 6 5% 0% 29 22% 133 100%Social Worker 25 16% 48 31% 41 27% 5 3% 1 1% 33 22% 153 100%Occupational Therapist 0% 1 100% 0% 0% 0% 0% 1 100%Total responses 98 23% 130 31% 86 21% 12 3% 2 0% 90 22% 418 100%

To what extent do you agree Better Access has contributed to improved mental health outcomes for children and young peopleStrongly Disagree Did not respond Total responsesStrongly Agree Agree Unsure Disagree


Component D - June 2010- Report Appendices - revision 2906 (9278415)



April 2010

39

OccupationNumber Per cent Number Per cent Number Per cent Number Per cent Number Per cent Number Per cent Number

Clinical Psychologist 37 28% 35 27% 29 22% 1 1% 1 1% 28 21% 131Psychologist 47 35% 32 24% 18 14% 3 2% 1 1% 32 24% 133Social Worker 22 14% 50 33% 43 28% 5 3% 0% 33 22% 153Occupational Therapist 0% 0% 0% 0% 0% 1 100% 1Total responses 106 25% 117 28% 90 22% 9 2% 2 0% 94 22% 418

To what extent do you agree Better Access has contributed to improved mental health outcomes for older people (i.e. those aged 65 + years)Strongly Disagree Did not respond Total reStrongly Agree Agree Unsure Disagree

Per cent100%100%100%100%100%

sponses

Q 56. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: Older people (i.e. those aged 65 + years).

Fifty three per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for older people. Two per cent of respondents disagreed with this statement. Twenty one per cent were unsure and 22 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for older people Respondents Per cent Strongly Agree 106 25% Agree 117 28% Unsure 90 21% Disagree 9 2% Strongly Disagree 2 0% Did not respond 96 23% Grand Total 420 100%

Fewer social workers agreed that the Better Access Initiative had contributed to more appropriate services for children and young people than did other occupational groups. The difference was approaching significance32.

32 Chi-squared 9.17, Degrees of freedom = 4, P= 0.06



June 2010

3.3 Comments from allied health provider survey

3.3.1 Profile of allied health respondents providing comment One hundred and seventy two (41 per cent) of all respondents to the survey provided comments. Of respondents providing comment, 61 per cent also provided a postcode. Of respondents providing a postcode of primary practice, 26 per cent were from Victoria, 23 per cent from NSW, 18 per cent from Western Australia and 16 per cent from Queensland. Eighty nine per cent of respondents providing comment and postcode were located in a major city (71 per cent) or inner regional area (18 per cent). Ten per cent were from outer regional areas and one per cent (one respondent) from a remote area.

Allied health comments by state and rurality

State Major

City Inner

Regional Outer

Regional Remote Missing State total

State valid per cent

VIC 20 6 1 27 26% WA 16 1 2 19 18% NSW 19 4 1 24 23% QLD 11 3 3 17 16% SA 5 1 6 6% TAS 5 1 6 6% ACT 3 3 3% NT 1 1 2 2% Missing 68 68 Total region 74 19 10 1 68 172 Region valid per cent 71% 18% 10% 1%

Of respondents providing comment, 41 per cent were social workers, 30 per cent clinical psychologists and 29 per cent psychologists. There were no comments by occupational therapists.

Allied health comment by occupation and region

Occupation Major

City Inner

Regional Outer

Regional Remote (blank) Occupation Per cent Clinical Psychologist 23 4 3 21 51 30% Psychologist 27 4 4 1 14 50 29% Social Worker 24 11 3 33 71 41% Total region 74 19 10 1 68 172 Region valid per cent 71% 18% 10% 1%

Component D - June 2010- Report Appendices - revision 2906 (9278415) - 40



June 2010

3.3.2 Comments received on survey Comments below are sorted by region, occupation and state.

Clinical Psychologist, Major City, VIC 1. The poor rebate for group sessions makes them untenable to run despite being highly effective and uniquely appropriate for children and adolescents, 2. Requiring a medical referral creates a major barrier - especially for adolescents. (#38)

Clinical Psychologist Major City, WA An item for autism assessment has been brought to the BAMH program in that it pays less in a rebate to the client than a standard clinical psychology item ($78.40 for the autism assessment item versus $115.05 for the standard 50 minutes plus appointment). (#213)

Clinical Psychologist Major City, NSW As a clinical psychologist I feel the client base under BAMH has been suitable to my training and experience. I worry that psychologists with less training and experience in mental health may not be providing the best-practice treatments to this client group. (#142)

Clinical Psychologist Major City, NSW As a Clinical Psychologist working in a so called ‘affluent area’, I found that my bulk billing clients referred under a care plan was highly beneficial to many disenfranchised people in this community. All referring GPs are aware of this. (#110)

Clinical Psychologist Major City, QLD Clinical Psychologists are trained in assessment, diagnosis and treatment of mental health issues. I do not believe patients should need a referral from a GP in which the GP assesses and diagnoses mental health issues as some GPs may have very limited training. (#300)

Clinical Psychologist Major City, WA Far too many under-trained psychologists are getting Medicare numbers (i.e. they have no Masters degree and are not specialist psychologists) and are trying to treat people who are too ill for them to assist. The patients need specialist psychological care. (#214)

Clinical Psychologist Major City, WA Feedback from patients tell me this initiative has made a huge difference to many people's lives enabling them to cope better in their respective circumstances. We must also be aware of what tragedies we are preventing in terms of suicide and long term s… (incomplete comment). (#271)

Clinical Psychologist Major City, NSW I believe, through comments from clients and talking with other colleagues, that the Better Access Initiative is making a very big impact on the accessibility and affordability of mental health services for a large proportion of Australians with mental health. (#76)

Clinical Psychologist Major City, NSW I bulk bill for the treatment of ex prisoners in an attempt to help them to integrate into the community and to lead productive lives. The recidivism rate for participants is 9%




June 2010

against 46% on a state basis for NSW thus saving the community many millions. (#169)

Clinical Psychologist Major City, WA I do not consider GPs acting at gatekeepers as a necessary function in accessing psychological services. It is costly for the system and the review process is costly for the clinician and places client confidentiality at risk. (#416)

Clinical Psychologist Major City, NSW I practise partly in an Aboriginal Medical Centre and this helps access. There are difficulties getting interpreters for CALD people. One other problem is that many of the patients change GPs in the course of treatment. (#157)

Clinical Psychologist Major City, SA I'm concerned about the quality of services provided by clinicians who are not clinical psychologists. (#98)

Clinical Psychologist Major City, WA It is a very positive initiative enabling people to access psychological services who most need them and who have difficulty affording them. Significant improvements in their mental health are the direct result and very much needed. (#22)

Clinical Psychologist Major City, VIC Limiting services for individuals to 12-18 sessions per year means treatment is often stop gap and inadequate. This population of patients, by definition, have significant issues which, to be adequately addressed, need more time. (#23)

Clinical Psychologist Major City, NSW Medicare items allow for 12 and up to 18 sessions of individual therapy per annum. plus 12 group sessions. I suggest 24 sessions and up to 30 sessions per annum IRRESPECTIVE of individual or group mode. This is more therapeutically useful. (#80)

Clinical Psychologist Major City, SA My responses “Don’t Know” are based on lack of information on my part. (#151)

Clinical Psychologist Major City, QLD Should be an item number for outcome and review reports for allied health practitioners. No need for patients to see GP for review, or in some cases initial referral. Perhaps up to 3 sessions without GP referral. (#106)

Clinical Psychologist Major City, WA The BAI has been invaluable in helping people access mental health services and educating GPs on the importance of identifying mental health issues (considering the prevalence and 'costs' of these problems). The latent need for it was seen in the initial . . . (incomplete comment) (#210)

Clinical Psychologist Major City, WA The initiative needs to take into consideration best practice guidelines for working with children and adolescents and allow sessions to be conducted with parents when the child is not present. (#262)




June 2010

Clinical Psychologist Major City, VIC The most co morbid, complex and severe level of depression, anxiety and other disorders are referred to clinical psychologists and these require far more than 12 to 18 sessions for evidence-based treatments. (#368)

Clinical Psychologist Major City, NSW This initiative has made mental health care more accessible to financially challenged community members and also resulted in GPs and Psychologists working together more effectively in the community. (#107)

Clinical Psychologist Major City, QLD This initiative should have started 30 years ago. It is evident from my experience that there are a significant number of people out there who need access to psychological services and over time this will be reflected not only in the improved mental health. . . . (incomplete comment) (#25)

Clinical Psychologist Major City, WA Two comments: 1) It adds to the expense of the system to have the Dr. do such an intensive referral when any competent clinical psychologist will do his or her own. The review similarly adds unnecessary expense for the system. (#156)

Psychologist Major City, WA Counselling psychologists are 6 year trained Master's or PhD graduates and should have access to Tier-1 Medicare rebates that Clinical psychologists do. 42% of counselling psychologists are in private practice and the government is not making good use of. . . . (incomplete comment) (#209)

Psychologist Major City, NSW GPP referrals are often missing vital information. Sometimes there is no paperwork at all!! There is also a confusion amongst GPs as to the period of time in which referrals can be made. The erroneous perception is that it is from, eg, August to August. (#413)

Psychologist Major City, ACT GPs do need more information about diagnosing Mental Health disorders. All health professionals involved in this initiative need more networking opportunities. (#113)

Psychologist Major City, WA I am advised that many service providers do not have appropriate training in the mental health conditions or indeed in mental health counselling. This is a serious concern and should NOT be addressed by one day workshops. (#288)

Psychologist Major City, VIC I am frustrated at the demarcation between clinical psychologists and registered psychologists. My clientele I imagine is identical to that of a clinical psychologist. It is time that someone really examined quite objectively the purported difference. (#119)

Psychologist Major City, WA I believe that generalist psychologists who can provide evidence of clinical practice from peer reviewed client files should be allowed to register as clinical psychologists. (#65)

Psychologist Major City, VIC I get concerned that people who can afford services are directly referred. I don’t believe GPs are reviewing that aspect of things, perhaps it is not within the scope of




June 2010

the scheme, eg. not means tested in any way, or had been considered by Government .(#75)

Psychologist Major City, WA I have people fly or drive from rural communities to see me or others in my practice. It would help them enormously if telephone counselling, particularly by skype (VoIP), could be included in the Initiative. (#143)

Psychologist Major City, VIC I have the impression there are already too many psychologists now in private practice, competing to obtain referrals from a limited number of GPs. However, the service distribution (of psychologists) appears to be concentrated in the inner city and. . . . (incomplete comment) (#61)

Psychologist Major City, NSW I work in a low income, high unemployment area and bulk bill a large percentage of my clients who would not have access to individual mental health services if they did not have the Medicare subsidy. (#186)

Psychologist Major City, NSW It’s difficult to ascertain the impact of the BAI when working with a restricted sample of the population. The prevalent belief among psychologists, which I share, is that the BAI has contributed to de-stigmatising mental illness by making services more affordable. (#28)

Psychologist Major City, NSW Level of Medicare rebate gives false impression that this is a satisfactory level of remuneration and/or income for professional psychological services provided in the context of private practice costs. Awareness raising about this could be a suitable. . . . (incomplete comment) (#94)

Psychologist Major City, NSW Many GPs are still not knowing about the Better Access Initiative. (#131)

Psychologist Major City, WA Only about 1% of clients are initially referred by GPs under this programme. The rest are people who contact me about an appointment and then on my advice they go to their GP for a formal referral. These people seem to seek out assistance from a psychologist. (#150)

Psychologist Major City, ACT The BOMHC initiative has enabled low income earners, unemployed, pensioners, etc. to receive quality psychological care where they would not have been able to access this in the past. This is the best thing to be introduced to the Australian people since . . . . (incomplete comment) (#171)

Psychologist Major City, VIC The key issue is getting people with mental health problems to seek help. Privacy and confidentiality is thus important. Requiring a GP referral adds a further hurdle that is off-putting to many who value privacy. The fact that a huge amount of the budget. . . . (incomplete comment) (#32)




June 2010

Psychologist Major City, VIC The lack of ability to use interpreters is a major concern for NESB patients. For children and adolescents, private practice may not always be the most appropriate place. For psychologists working in high NESB communities and low SES, there is considerable . . . . (incomplete comment) (#114)

Psychologist Major City, NSW The narrow range of supported therapies is not necessarily in patients' best interests, as some may benefit from more appropriate therapies that are not included under Better Access protocols. (#146)

Psychologist Major City, VIC The provision of 6 to 12 sessions for many psychological issues is unrealistic. particularly for drug and alcohol related issues. and it seems to me that this arbitrary figure is wrongly setting up expectations that mental health issues ought to be 'fixed.' (#42)

Psychologist Major City, QLD The referral system through GPs is good as they obviously see a lot of people who suffer from mental health problems and can direct them to assistance that the patient otherwise may not access. However the review process for psychologists (reports after. . . . (incomplete comment) (#26)

Psychologist Major City, WA

The survey doesn't really capture the problems with the Better Access Initiative, nor the issues around how it is being (mis)used. For example, "access" may have improved, but quality has reduced: Many GPs seems to have a standard practice of diagnosing . . . . (incomplete comment) (#237)

Psychologist Major City, QLD The system procedures are limiting GPs and psychologists from using the program. (#96)

Psychologist Major City, NSW There are great impediments for providers who wish to bulk bill including the lack of resources in GP software to add on psychologists, making it at least a five week wait until being paid. If the government. wishes psychologists to consider bulk billing for . . . . (incomplete comment) (#144)

Psychologist Major City, QLD There are too many restrictions in the program for assisting children - child clinical work often involves working with the parents or conducting family therapy rather than seeing the child on their own which is a condition of the scheme. (#95)

Psychologist Major City, QLD The Better Access initiative has made access to mental health services more accessible for many people who couldn't previously afford the services and it has made it more practicable for mental health workers to provide services to disadvantaged people by . . . . (incomplete comment) (#102)




June 2010

Psychologist Major City, QLD This initiative has been instrumental in providing quality support and treatment for ordinary Australians struggling with the impact of a mental disorder. Almost all of my clients could not access such care and treatment without the access to Medicare . . . . (incomplete comment) (#33)

Psychologist Major City, SA This initiative has not only allowed those unable to afford/access services, it would seem to have a preventative effect for people graduating to more serious mental health problems. (#218)

Social Worker Major City, VIC Access for CALD people depends on availability of bulkbilling practitioners like me. (#327)

Social Worker Major City, VIC Always chasing up appropriate referral information from GPs such as referral letter, they usually send copy of MHCP. Constantly educating GPs and informing them that I have the same clinical skills as a Psychologist, and have to prove myself to GPs . . . . (incomplete comment) (#399)

Social Worker Major City, NSW As a private practitioner, I notice that the people coming to me are not substantially different to those who came previously. They seem to be largely people who know how to get access to resources that they would otherwise have paid for themselves. (#8)

Social Worker Major City, VIC As a Social Worker with a Masters Degree in Child and Adolescent Psychotherapy, I have worked in private practice for over 20 years. My practice concentrates on treating children with complex mental health needs such as anxiety and depression, suicidal . . . . (incomplete comment) (#363)

Social Worker Major City, QLD As a social worker, I am as yet uncovered by private health insurers. The inclusion of social workers in the Better Access program has enabled me to ensure access and equity to my clients. For economically disadvantaged clients, I now bulk bill, which has . . . . (incomplete comment) (#347)

Social Worker Major City, VIC Can we have some additional items like case management, family work, more sessions before report is needed, payment for reports and missed sessions. Same payment for social workers as psychologists and additional refunds for practitioners who solely bulkbill. (#162)

Social Worker Major City, NSW Children and adolescents are being referred as patients. Often the best treatment is to educate parents about how they can assist their child but the parent does not have the referral . . . . (incomplete comment) (#394)

Social Worker Major City, VIC Clients have commented that they would not have been able to access counselling without the GP referring them through this program. (#269)




June 2010

Social Worker Major City, NSW Firstly, I am concerned that the seriously mentally ill are being referred to private practitioners who are not able to manage them effectively and safely in the community. We need to absolutely ensure that community based services are ALSO adequately . . . . (incomplete comment) (#280)

Social Worker Major City, WA For many clients it has 'mainstreamed' primary mental health care and been the tipping point for many to seek help when they may not have previously, or might have waited for a major crisis before being medicated, hospitalised or separating or divorcing. (#379)

Social Worker Major City, VIC I am unsure if indigenous and CALD patients are accessing services as I haven't received any referrals for these patients. I would also like to say that 12sessions with the possibility of another 6 is very limited and that there are times when the . . . . (incomplete comment) (#410)

Social Worker Major City, VIC I am very unclear why mental health social workers providing focused psychological strategies are rebated less than registered psychologists. It would help us as a professional group to be treated fairly. (#276)

Social Worker Major City, VIC I can only comment on my client load, I am seeing older people, people who have come for the first time, and those who have sought help at earlier times and now have a little extra help to help with current stresses. (#285)

Social Worker Major City, VIC I have some reservations about the 'appropriateness of services' and 'better outcomes' under the initiative. I strongly support the initiative but believe that the treatments available under it are too limited both in the treatment modalities offered as . . . . (incomplete comment) (#258)

Social Worker Major City, SA I think it an excellent initiative and believe many patients are benefiting from it enormously. I bulk bill most of my Better Access patients and many of these people are getting assistance where they would not have access to the public system or some . . . . (incomplete comment) (#283)

Social Worker Major City, ACT I use Better Access as a bulk billing opportunity for clients who may have multiple issues and do not readily fall into public mental health categories (ie not e=acute enough). A major issue is 'do not attends' - which has in the past 6 months halved my . . . . (incomplete comment) (#415)

Social Worker Major City, NSW It's very difficult to network with GPs about services a mental health social worker can provide and why they would choose to refer to one over a psychologist. (#318)




June 2010

Social Worker Major City SA My suggestion is to include family therapy in the Better Access program. I feel families as part of treatment process need to be included as well along with individual therapy. (#250)

Social Worker Major City, VIC Some people are concerned that private health insurers will be able to know they have accessed mental health services under the Better Access Initiative - and therefore don't access the service or pay the full fee despite being financially stressed. (#330)

Social Worker Major City, QLD The anomaly between social work and clinical psychology and psychology rates needs to be removed. Most Mental Health social workers enter private practice after many years of practice and experience in the public sector and are very skilled. (#378)

Social Worker Major City, NSW The report writing requirements are excessive and extremely time consuming, a standard pro forma document needs to be created and applied across all disciplines. The rebate for social work needs to be in line with psychology. (#313)

Social Worker Major City, WA There is a reluctance by GPs, Psychiatrists and Mental Health Services to refer to Clinical (Mental Health Social Workers) because they do not know that we have special, adequate and relevant training and experience to provide mental health services. (#337)

Social Worker Major City, QLD There should be equity in financial remuneration for practitioners, eg. Social workers providing services under this scheme should receive the same payment from Medicare as clinical psychologists do. (#376)

Social Worker Major City, VIC There were already many appropriately qualified and skilled practitioners before this program. The value is in making it accessible to all. The financial circumstances of my referrals has not changed under this scheme. (#292)

Clinical Psychologist Inner Regional, VIC As a Clinical Psychologist, I am asked to work with the full range of mental health disorders, therefore the option to extend to a full 48 sessions would seem warranted, as opposed to non-specialist psychologists, occupational therapist and social workers (#159)

Clinical Psychologist Inner Regional, WA Item 2712 is unnecessary. Require a 90min+consultation item. GP referral is unnecessary. Travel and administrative time needs to be covered. Bulk billing in a rural situation so as to provide access for psychological treatment requires compensation. (#417)

Clinical Psychologist Inner Regional, NSW My practice is in a rural area. Most of my clients now have Mental Health plans, however, there has been no significant change in the type of client that I am seeing in terms of their demographics. (#19)




June 2010

Clinical Psychologist Inner Regional, NSW There is a significant shortage of Clinical Psychologist in rural areas. (#18)

Psychologist Inner Regional, VIC I found the above questions difficult to answer, because you failed to provide a 'not applicable' or 'not relevant' option. I don't work with people in remote areas, nor Torres Strait Islander people, nor people from C & LDB, so I can't accurately answer. (#34)

Psychologist Inner Regional, VIC Putting clinical psychs on higher level is not supported by any evidence. I am a counselling psychologist with more training and experience than most clinicals, but am considered a 'registered psychologist' only. (#17)

Psychologist Inner Regional TAS Sorry about the content of the survey - very light-on in terms of teasing out some of the difficulties. We have an excess of clients wanting to access the BA initiative, but not enough allied health professionals and no psychiatrists in pp. (#178)

Psychologist Inner Regional VIC The two tier rebate system for clinical and generalist psychologists is unfounded and discriminatory. As a "generalist" psychologist in a regional area I receive referrals for people with chronic and complex mental health problems. (#123)

Social Worker Inner Regional VIC Needs to be an incentive to bulkbill as per what GPs get to increase accessibility for people on healthcare cards. Social workers need to be renumerated on the same rate as Psychologists. (# 312)

Social Worker Inner Regional NSW I undertake a number of home visits under Better Access. These are to the aged, those with transport or mobility issues, and those people who do not have the capacity to attend appointments in an office. (#392)

Social Worker Inner Regional QLD Another positive has been building closer relationships between GPs and Allied Health Providers. With regard to fees, I don't understand the rationale for Social Workers and Occupational Therapists receiving a lower rate than psychologists when they are . . . . (incomplete comment) (#360)

Social Worker Inner Regional NSW Better access has given people in rural and remote communities (rrc's) access to services that were just not available to them previously (I work in such an area). Most people in these areas are very poor and bulk billing is essential. (#291)

Social Worker Inner Regional QLD Differential rebates for psychologist and social workers and occupational therapists is a continuing lack of parity and limits the number of bulk billing clients that social workers and OT's can carry. (#252)

Social Worker Inner Regional QLD I am puzzled as to why several GPs in my area don’t refer patients to anyone for mental health problems. (#314)




June 2010

Social Worker Inner Regional TAS I believe that the therapy I do as a social worker is often more effective than some of the more rigid approaches of psychology. I have a Master of Social Work - 7 years' university study and many years tertiary study in therapies. Why do I receive less rebate? (#315)

Social Worker Inner Regional TAS I have been bulk billing a number of clients that otherwise would not be able to access services. The problem I come across is when I am doing assessments for the paediatricians. There is about 4 hours work in scoring assessments such as for Asperger's. (#353)

Social Worker Inner Regional TAS I have found it very difficult to access referrals. GP's specialists appear very interested and then simply don't refer. I would question if it is related to me being Social Work Trained because the question always arises as to whether I am psychology . . . . (incomplete comment) (#343)

Social Worker Inner Regional TAS I noted the information on mental health care plans as ‘fair' - it varies from poor - virtually nothing written - to very good. Most GPs provide adequate information. (#407)

Social Worker Inner Regional VIC This initiative has made high quality counselling available to people who are struggling financially. Especially as some counsellors bulk bill clients. (#375)

Clinical Psychologist Outer Regional SA Accessing Better Access in the area I work is dependent on the attitude of the GPs toward mental health and psychotherapy. I find some see the value and some don't and prefer to rely on medication only. (#124)

Clinical Psychologist Outer Regional NT Better Access should also provide for older people with depression along with dementia; or anxiety and depression related to stroke etc. It needs to be better promoted amongst individuals who come from CALD backgrounds. (#127)

Clinical Psychologist Outer Regional QLD The majority of my clients come through better Access referral and would not have been able to afford private psychological services without the scheme - especially young people and older people. I believe this has made an important difference to health outcomes (#377)

Psychologist Outer Regional QLD As a private practitioner I have found that the Better Access Initiative has decreased my income as most individuals request bulk billing, which has led to my hourly rate going from $180 per hour to $78 per hour as doctors are referring people who cannot afford to pay full fee (#58)

Psychologist Outer Regional VIC Despite this, some GPs are still "too busy" to make full use of the initiative such that the gatekeepers are not referring until the patients reach crisis point. (#86)




June 2010

Psychologist Outer Regional WA My clients report that they are highly appreciative of the Better Access Initiative. (#244)

Psychologist Outer Regional NSW The Better Access initiative has meant that these services can be provided in the regional and remote community in which I both live and practice. I also want noted that I bulk bill most individuals. (#126)

Social Worker Outer Regional WA As a private practitioner working in an allied health practice of four people - and pre-dating the Better Access initiative - I can confidently assert that Better Access has improved significantly access to appropriate mental health services for the people. (#324)

Social Worker Outer Regional TAS As I am rather remote from many others in private practice, it is difficult for me to answer some of the questions. The initiative has certainly enabled most of the people I see to access support that they otherwise would not be able to. (#338)

Social Worker Outer Regional TAS There is a definite lack in all areas for the provisions of service for most groups in the north west coast of Tasmania with the lack of service providers and mental health facilities in this region. The lack of adequately qualified and trained clinician . . . . (incomplete comment) (#298)

Social Worker Outer Regional QLD Yes I have a strong view that reports to doctors as part of referrals should be paid for by Medicare. It is unacceptable that we are required to complete these reports without remuneration. (#358)

Psychologist Remote NT In my opinion, Better Access has transformed the public's access to psychologists in private practice and has vastly increased the public's ability to choose between treatment approaches and different psychologists - more likely resulting in better client- outcomes (#72)

Clinical Psychologist Missing I am very pleased to have the opportunity make some comments about the Better Access Initiative, especially to an independent body. Better Access has provided an excellent opportunity for members of the community in need to access appropriate mental health. (#163)

Clinical Psychologist Missing As clinical psychologist often get referred more complex cases where psychological treatment requires more than 12 sessions. (#225)

Clinical Psychologist Missing Better Access has provided opportunities for those who cannot access public mental health clinical psychologists due to demand and service restrictions (#62)

Clinical Psychologist Missing Clinical Psychologists are required in mental health services and hospitals not in private practices which are geographically limited. Better to use funds to provide well paid clinical psychologist posts in specialist services as are needed. (#170)




June 2010

Clinical Psychologist Missing I also work in a rural community where Better Access is not available. There, clinical psychologists provide psychological services under the Better Outcomes in Mental Health Care via a Division of General Practice. (#135)

Clinical Psychologist Missing I have some reservations about 4 year trained psychologists working with clients with complex issues (there is no practicum component to the university course at undergraduate level). I also think it should be compulsory to produce some type of standard. . . . (incomplete comment) (#235)

Clinical Psychologist Missing I think the better initiative could be strengthened for children and young people if it was recognised that some appointments need to be with the parent alone, and they were reimbursed for these. It is not always helpful or productive in treatment to see only the child (#238)

Clinical Psychologist Missing

In my view, this service is serving the community well, and providing considerably better services to those in our community who have mental health problems. However, for those with Axis 2 disorders (personality disorders etc), there are far too few sessions. (#287)

Clinical Psychologist Missing It is a great initiative. Lots of people need help but may not be acutely unwell enough to go into the public system. This initiative has closed the gap and has helped many people in the community. (#217)

Clinical Psychologist Missing It is good that many people who would not meet the criteria for Mental Health Clinics can assess treatment through this service, however, I note that many patients who are accessing Better Access are in fact financially able to access a private Clinical Psychology services (#203)

Clinical Psychologist Missing It is my experience that people who previously could not afford to access high quality psychological care are the major beneficiaries of this initiative and this allows them to address their issues earlier thus being more preventative (#201)

Clinical Psychologist Missing It would be helpful to abolish the six session review - GPs always approve further sessions anyway. GPs require further information about eligibility for further sessions, ie the confusion between the anniversary date of the plan, the notion of calendar years (#132)

Clinical Psychologist Missing Overall BAI helpful. however, suggests to public that all problems are treatable in 12 (or occasionally 18) sessions which is not true, does not account for psychological treatment for people with severe PD and in fact may be iatrogenic for these; does not pay non . . . . (incomplete comment) (#160)




June 2010

Clinical Psychologist Missing People have concerns that most of the psychological services are being delivered within the relatively wealthy eastern and northern suburbs of Sydney. I think there are two points worth considering. Firstly, this is where, prior to 2006 most private psychologists were located. . . . (incomplete comment) (#48)

Clinical Psychologist Missing Some key conditions of child psychopathology (e.g. Autism) are not included in the initiative and this causes significant difficulty for some of the most needy families. We have seen a major increase in low-income families (in western Sydney) bringing children (#234)

Clinical Psychologist Missing The Better Access Initiative has, on the whole, made a big difference to the accessibility of services to the general community. I'm not sure about some groups and have indicated this above. For rural and remote communities I think we should work toward . . . . (incomplete comment) (#14)

Clinical Psychologist Missing The impact of 'psychologists' referrals vs. Clinical Psychologists referrals should be explored. Psychologists, whom have half the training of Specialists are now dominant in the field to the extent that Clinical Psychologists positions are now threatened . . . . (incomplete comment) (#219)

Clinical Psychologist Missing The information available to psychologists re administrative issues has been inconsistent, especially when contacting Medicare eg. how long a current referral is valid, whether a written referral is required etc. Locating information on the Medicare website. (#167)

Clinical Psychologist Missing The initiative does not adequately address the appropriate and empirically supported treatments for young people. It needs to further investigate treatments options such as family therapy and parent sessions/therapy. It needs to allow for parents to be seen separately (#87)

Clinical Psychologist Missing The lack of formal overall evaluation of the efficacy of services being offered by private practitioners needs to be addressed. (#196)

Clinical Psychologist Missing There are some very poorly prepared psychologists rendering services under this initiative. (#188)

Psychologist Missing Because children need adults to supervise their health and development, there should be provision for counselling sessions/interviews with parents without the child present. It is often not appropriate to discuss the child's difficulties with the child present. (#187)

Psychologist Missing Better Outcomes has made mental health services available to those individuals who before did not have access to a mental health service. Individuals who previously could




June 2010

not afford private rates and whose illness was classed as not severe enough as requiring public mental health care (#184)

Psychologist Missing Extreme need for neuropsychology services to be added in to assist in ax and tx plans for mental illness. (#66)

Psychologist Missing I am unsure of the advantages to people in remote communities - would probably depend if there were Psychologists in the local area. I think it would be beneficial if there was some provision for phone sessions to improve access. (#108)

Psychologist Missing I do not entirely agree with the rebate split between psychologists and clinical psychologists. As a psychologist, my training and experiences makes me qualified to provide psychological treatment so the distinction for me, personally, is significantly f. . . . (incomplete comment) (#158)

Psychologist Missing I have had many individuals comment that they have accessed the service via their GPs through personal referral because it is personal and not agency based. (#103)

Psychologist Missing I have no exposure to some of the target population. (#233)

Psychologist Missing I work primarily with Ethnic Chinese community. It is well documented in Cross Cultural Mental Health Literature across the world that Chinese tended to have a low MH service usage. With the Better Access initiative, there are many Chinese clients seek psychologists (#55)

Psychologist Missing In the low income area where I practice, it would be impossible to earn a sufficient wage to justify offering psychological counselling there without Better Outcomes. At present with the reduced funds available through Better Outcomes, I am having to look a. . . . (incomplete comment) (#154)

Psychologist Missing People who previously could not afford psychological services can now receive help. I believe in bulk billing clients when this is needed but I know other psychologists who are reluctant to do so. (#290)

Psychologist Missing Some doctors still do not appear to support the initiative wholeheartedly, and question the legitimacy of patients' entitlement to psychological services. (#128)

Psychologist Missing The current two tier system for psychologists is unfair and divisive. There needs to be only one level of rebate for all psychologists. (#83)

Psychologist Missing The face to face requirement of services provided by psychologists is a major hindrance to people from rural and remote areas in accessing services. The problem is




June 2010

not one of a lack of psychologist but one of a lack of psychologists in rural areas. (#278)

Psychologist Missing The two tier system for psychologists appears to have had unintended consequences on demand for one type of academic training, and demand for services offered by Clinical psychologists at a higher rebate. The distinction in actual services offered between . . . . (incomplete comment) (#11)

Social Worker Missing Improvement of referrals from Doctors will occur only if the doctors each have a data base of allied mental health profession to whom they could refer in their area. Alongside each name, there could be appropriate information such as the type of service. (#384)

Social Worker Missing As a Social Worker, I would like to see more promotion of Social Workers as skilled professional practitioners to GPs and Psychiatrists. Often equally trained and skilled in psychological practice as Psychologists, we do not receive the same recognition. (#299)

Social Worker Missing As a social worker, with much training and experience, I would like us to receive the same rebate as psychologists. We have specific training in service provision to CALD people. When referrals are made for young people or children, the parents usually . . . . (incomplete comment) (#387)

Social Worker Missing GPs appear reluctant to refer to social workers. The wording in the Medicare information is biased towards psychology. (#348)

Social Worker Missing GPs are continuing to prefer to refer to Psychologists rather than Mental Health Social Workers like myself. More people with anxiety or depression related disorders could have access to effective treatment if did not have to get a referral from a GP. (#304)

Social Worker Missing I believe that it has caused a great division between psychologists and social workers with psychologists believing they are superior to social workers. I'm not sure about the occupational therapists. This is extremely disappointing professionally. (#391)

Social Worker Missing I do ask about nationality and Aboriginality and I do not see a lot from diverse groups - it could be because of the location I work in. I operate in a low socio-economic area and bulk bill and operate out of a GP surgery - it provides counselling at the . . . . (incomplete comment) (#326)

Social Worker Missing I feel GPs are referring to private practice without considering community based alternatives which are often more affordable for the client so this blows out the overall Medicare budget. There is a strong bias towards psychologists from medical personnel (#302)




June 2010

Social Worker Missing I feel it has been a great initiative and made psychological services much more accessible for people who would not ever thought of seeking this kind of help. (#5)

Social Worker Missing I strongly believe the initiative has allowed faster and cheaper outcomes for mental health patients. I have heard some comments that it is expensive in that it allows subsidised services for the "worried well" and would dispute this on the grounds that t. . . . (incomplete comment) (#335)

Social Worker Missing I think this program does not recognise the experience and abilities of some social workers who have been working as specialised clinicians for 20 or 30 years. I am a senior social worker with 2 degrees (including first class honours) and a five year clinical Masters (#296)

Social Worker Missing I work in a GP Private Practice and there is little incentive to work for extended time periods with clients when you receive the same amount if you see someone for 20 minutes or if you see them for 1 hour. (#279)

Social Worker Missing Increase in remuneration for in home visiting of clients, particularly elderly or rural to assist promote flexible service delivery. (#346)

Social Worker Missing It allows services to mildly mentally ill in a preventative way. The effects of this show over time, and need to be evaluated as such. (#402)

Social Worker Missing It is a pity that the allied health providers such as social workers who tend to charge less for similar services, or bulk bill all or many of their clients, are not referred to more regularly. I would like to see the statistics on fees which are being charged. (#370)

Social Worker Missing It is very unjust that Accredited Mental Health Social Workers receive so much less of a rebate (payment) under this scheme. I have 2 University Degrees and a Postgraduate Qualification in Social Work and over 20 years Clinical Social Work experience, inc. . . . (incomplete comment) (#294)

Social Worker Missing More education is required for GPs regarding the ability and expertise in providing mental health counselling and are in most instances quite surprised to learn that allied health, eg social workers, are qualified to provide mental health services to patients. (#270)

Social Worker Missing People who would not normally get assistance with distress and life catastrophes are being assisted in a timely and effective way. I don't know how some of the people I have seen would have managed. People have a chance to be more functional and effective. . . . (incomplete comment) (#373)




June 2010

Social Worker Missing Referral Pathways for Social Workers need to be included in all other people available for referral. (#272)

Social Worker Missing Social workers who have completed PhDs should gain EQUALITY of rebate with clinical psychologists. (#383)

Social Worker Missing The BAI is not used by many GPs in Alice Springs. Very few different GPs have referred to me. (#259)

Social Worker Missing The Better Access initiative has significant contribution to early detection and treatment of mental health issues. This compliments the public services and address a very significant clinical service gap. (#369)

Social Worker Missing The discrepancy in rebates provided to the different allied health providers does not allow clients to fairly access services of their choice. I have clients who want to see me as a mental health social worker and express a desire to see me. . . . (incomplete comment) (#411)

Social Worker Missing The restrictions on number of sessions under the BAI means that allied health professionals cannot provide longer term treatment to people who require this type of care. They are still forced to see psychiatrists in the public or private sector and this is . . . . (incomplete comment) (#354)

Social Worker Missing The service benefits these groups in a significant way. However as a social worker, I will not be able to continue providing this service because the Medicare bulk bill rebate is too low. I am not able to cover my cost. 274

Social Worker Missing There are continual barriers as a Social Worker to accessing GP services under Better Access as they are now referring to other internal Mental Health programs in Div of GP that has less paperwork requirements. (#395)

Social Worker Missing There are numerous issues re the Better Access Scheme providing access - eg for CALD communities it does not fund interpreters, a significant gap. In my experience virtually everyone, regardless of income, is coming to counselling through the Better Access. (#408)

Social Worker Missing There should be a Medicare item that allows for couple counselling and family therapy because many people's families need support and advice on how to add value to individual therapy. (#305)

Social Worker Missing This initiative is very important for people on low incomes to receive treatment and for clients to be able to self select their therapist. (#397)




June 2010

Social Worker Missing Unable to comment on rural, remote communities and children as I have received no referrals from those areas. (#374)

Social Worker Missing Whilst I am a specialist Mental Health Social Worker, referral letters from GPs still refer to the Better Access to Psychiatrists, Psychologists and General Practitioners Scheme - Social Workers should be identified as a specialist discipline alongside psychology (#323)

Social Worker Missing Yes I would have liked to receive this survey earlier (only received this 22-7-09) (#247)




June 2010

4 Survey of GPs and psychiatrists

4.1 Sampling Information on the evaluation and hyperlink to the online survey was forwarded by email to the state branches of the RACGP and RANZCP for forwarding to their members.

The survey was live for a three week period. There were a total of 203 respondents to the survey.

Note that unless otherwise stated, no tests of statistical significance were conducted given the relatively small size of the samples.

4.2 Responses to survey of GPs and psychiatrists Q1. What is your occupation?

Respondents comprised 193 GPs, eight psychiatrists, two paediatricians and two respondents who did not provide their occupation.

Occupation Respondents Per cent General Practitioner 193 95% Psychiatrist 8 4% Paediatrician 2 1% Grand Total 203 100%

Q2. Has the Better Access initiative affected access to clinical training in your discipline?

The majority of respondents (54 per cent) indicated that they did not think the Better Access Initiative had improved access to clinical training. Forty three per cent of respondents believed that clinical training had been affected.

Affected access to clinical training Respondents Per cent No 110 54% Yes 88 43% (blank) 5 2% Grand Total 203 100%




June 2010

Q2a. Has the Better Access initiative affected access to clinical training in your discipline? If yes, has it improved access or made it more difficult?

Of those respondents who believed that clinical training had been affected by the initiative (43 per cent), 89 per cent believed that it had improved access while eight per cent believed that it had made access more difficult.

Impact on access to clinical training Respondents Per cent Improved access 78 89% Made it more difficult 7 8% (blank) 2 2% Grand Total 88 43%

Q3. Do you work in a private practice or in both private and public practice?

Approximately 80 per cent of the respondents worked in private practice only, with about 20 per cent working in both public and private sectors.

Working in private and public practice Respondents Per cent Both public and private 44 22% Private 158 78% (blank) 1 0% Grand Total 203 100%

Q4. How long have you been in private practice?

Approximately two thirds (64 per cent) of respondents had been in private practice 11 or more years. Those with less experience in private practice (five years or less) were equally likely to work in both public and private sectors (16 per cent of respondents work in public and private practice) or in the private sector alone (16 per cent of respondents work in only the private sector).

Private practice Both public and private All respondents Time in private

practice Respondents Per cent Respondents Per

cent Respondents Per cent

Less than 2 years 4 3% 2 5% 6 3% 2 to 5 years 21 13% 5 11% 26 13% 6 to 10 years 24 15% 4 9% 28 14% 11 to 20 years 43 27% 7 16% 50 25% 21 years and over 64 41% 16 36% 80 39% (blank) 2 1% 10 23% 12 6% Total 158 100% 44 100% 202 100%




June 2010

Q5. On average, how many hours per week do you work in your main private practice?

Overall, 43 per cent or respondents reported working 30 hours or less per week and one third reported working between 31 and 45 hours per week in private practice. Sixteen per cent of respondents reported working 46 or more hours per week.

Of the respondents who worked in both public and private sectors, 18 per cent worked 15 hours or less per week in private practice, 20 per cent worked 16-30 hours per week and 36 per cent worked 46 hours or more. Of those who worked in private practice alone, 43 per cent worked 30 hours or less, 35 per cent worked 31-45 hours per week and 18 per cent worked 46 hours or more.


Hours worked per week Respondents Per cent Respondents Per

cent Respondents Per cent

1 to 15 hours per week 24 15% 8 18% 32 16% 16 to 30 hours per week 45 28% 9 20% 54 27% 31 to 45 hours per week 55 35% 12 27% 67 33% 46 + hours per week 29 18% 4 9% 33 16% (blank) 5 3% 11 25% 16 8% Grand Total 158 100% 44 100% 202 100%




June 2010

Q6. Since 1 January 2009 have you claimed for seeing patients with a mental disorder for any of the following MBS item numbers?33

• 291: Referred patient assessment and management plan • 293: Review of management plan • 296: Initial consultation on a new a patient – in rooms • 297: Initial consultation on a new a patient – in hospital • 298: Initial consultation on a new a patient – home visit Since 1 January 2009, almost 90 per cent of respondents have claimed for seeing patients with a mental disorder. Of those respondents working solely in private practice, 92 per cent had claimed for seeing a patient with a mental disorder, whilst 77 per cent of the respondents working in both private and public practice had claimed for seeing patients with a mental disorder.

Private practice Both public and

private All respondents Claimed for seeing a patient with a mental disorder since January 2009 Respondents



Per cent

No 6 4% 1 2% 7 3% Yes 145 92% 34 77% 179 89% (blank) 7 4% 9 20% 16 8% Total 158 100% 44 100% 202 100%

33 Note: Drop down menus in the web-based survey may mean variation in questions numbering across

provider groups. The text reflects the question asked.




June 2010

Q6a. Since 1 January 2009, how many patients have you referred to GPs/ Psychiatrists/Paediatricians through the Better Access initiative?34

Since 1 January 2009, 38 per cent of respondents reported referring 20 or fewer patients to GPs, psychiatrists or paediatricians through the Better Access Initiative and two thirds reported making 21 or more referrals.

Of those respondents working solely in private practice, 62 per cent reported referring 21 or more patients and 29 per cent reported 51 or more. Respondents working in public and private practice made fewer referrals, with more than half reporting that they had made 21 or more referrals and 21 per cent reporting that they had made 51 or more referrals.


Number of patients since January 2009 Respondents



Per cent

1 to 10 patients 17 11% 7 21% 24 13% 11 to 20 patients 37 26% 7 21% 44 25% 21 to 50 patients 48 33% 12 35% 60 34% 51 to 100 patients 28 19% 3 9% 31 17% 101 + patients 15 10% 4 12% 19 11% (blank) 0 0% 1 3% 1 0% Total 145 100% 34 100% 179 100%

Q7. Who do you refer patients to for treatment of their mental disorder?

Seventy seven per cent of GPs reported that they referred to clinical psychologists, less than 60 per cent reported referring to psychologists, twenty per cent referred to social workers and ten per cent reported referring to occupational therapists.

GPs referring to Number

of GPs Per cent

of GPs Psychiatrist 124 61%Clinical psychologist 157 77%Psychologists 120 59%Social worker 40 20%Occupational therapist 21 10%Total respondents reporting nature of referrals 203

34 Note: Drop down menus in the web-based survey may mean variation in questions numbering across

provider groups. The text reflects the question asked.




June 2010

Q8. In referring a patient with a mental health disorder to an allied health professional (psychologist, occupational therapist or social worker) through Better Access what are the key factors influencing your decision?

Professional skill and competence (19 per cent) and cost (18 per cent) were identified as the biggest influences on referring a patient whilst information on waiting times was the least influential. One respondent reported that they do not refer to allied health professionals.

Influence on decision Respondents Per cent Professional skill and competence 122 19% Cost 112 18% Established relationship 97 15% Location 89 14% Area of specialisation 66 10% Professional group 45 7% Information on waiting times 36 6% Do not refer to allied health professionals 1 0% (blank) 62 10% Grand Total 630 100%

Q9. Since 1 January 2009, on average how would you rate the information provided to you in the GP Mental Health Care Plan from the referring GP?

Overall, the majority (53 per cent) of respondents reported the information provided in the GP Mental Health Care Plan as good (26 per cent) or fair (27 per cent). Eighteen per cent rated the information provided as very good. Thirteen per cent rated the information provided as poor or very poor.

There were only slight differences in the views held by respondents working solely in private practice and those working in both public and private practice.

Private practice Both public and

private All respondents Quality of information provided in GP care plan Respondents Per


cent Very Good 30 19% 6 14% 36 18% Good 42 27% 10 23% 52 26% Fair 47 30% 7 16% 54 27% Poor 12 8% 4 9% 16 8% Very poor 8 5% 2 5% 10 5% (blank) 19 12% 15 34% 34 17% Total 158 100% 44 100% 202 100%


Component D - June 2010- Report Appendices - revision 2906 (9278415) -



June 2010

65

Q10. Of those patients referred to you through the Better Access initiative since 1 January 2009, please estimate the percentage who are receiving treatment for their mental disorders for the first time?

Twenty nine per cent of respondents reported that more than 61 per cent of referrals were receiving treatment for their mental disorder for the first time, and 6 per cent reported that more than 81 per cent of their referrals were receiving treatment for the first time.

There was little difference in the perceptions reported by respondents working solely in private practice and those working in both public and private practice.

Private practice Both public and private All respondents Referrals receiving

treatment for first time Respondents Per


cent 0 to 20 % 18 11% 3 7% 21 10% 21 to 40% 30 19% 9 20% 39 19% 41to 60% 42 27% 8 18% 50 25% 61 to 80% 42 27% 5 11% 47 23% 81 to 100% 8 5% 4 9% 12 6% (blank) 18 11% 15 34% 33 16% Total 158 100% 44 100% 202 100%



June 2010

Q 27. To what extent do you agree with the following statement: the Better Access initiative has contributed to mental health services becoming more affordable.

Eighty eight per cent of respondents strongly agreed with the statement that the Better Access Initiative has contributed to mental health services becoming more affordable. Six percent of respondents disagreed with this statement. Five per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to services being more affordable Respondents Per cent Strongly Agree 125 62% Agree 53 26% Unsure 10 5% Disagree 7 3% Strongly Disagree 6 3% Did not respond 2 1% Grand Total 203 100%




June 2010

Q 28. To what extent do you agree with the following statement: the Better Access initiative has contributed to more allied health professionals (clinical psychologists, occupational therapists, psychologists and social workers) providing mental health services in the community.

Eighty three per cent of respondents reported that they agreed with the statement that the Better Access Initiative has contributed to more allied health professional providing mental health services in the community. Three percent disagreed with this statement. Twelve percent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to more allied health services in the community Respondents Per cent Strongly Agree 95 47% Agree 73 36% Unsure 24 12% Disagree 7 3% Strongly Disagree 0 0% Did not respond 4 2% Grand Total 203 100%




June 2010

Q29. To what extent do you agree with the following statement: the Better Access initiative has contributed to more GPs providing mental health services.

Fifty one per cent of respondents reported that they agreed with the statement that the Better Access Initiative has contributed to more GPs providing mental health services. Seventeen per cent disagreed with this statement. Thirty one per cent of respondents reported that they were unsure and one per cent did not respond to this question.


Q30. To what extent do you agree with the following statement: the Better Access initiative has contributed to psychiatrists being more accessible.

Ten per cent of respondents agreed with the statement that the Better Access Initiative had contributed to psychiatrists being more accessible. Sixty one per cent disagreed with this statement. Twenty six per cent per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to more psychiatrists being more accessible Respondents Per cent Strongly Agree 7 3% Agree 15 7% Unsure 52 26% Disagree 68 33% Strongly Disagree 56 28% Did not respond 5 2% Grand Total 203 100%




June 2010

Q31. To what extent do you agree with the following statement: the Better Access initiative has contributed to more culturally and linguistically diverse mental health services.

Twenty one per cent of respondents agreed with the statement that the Better Access Initiative had contributed to more culturally and linguistically diverse mental health services. Twenty six per cent disagreed with this statement. Fifty one per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to more culturally and linguistically diverse mental health services Respondents Per cent Strongly Agree 15 7% Agree 29 14% Unsure 104 51% Disagree 34 17% Strongly Disagree 18 9% Did not respond 3 1% Grand Total 203 100%

Q32. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People with anxiety or depression related disorders.

Ninety four per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making mental health services more accessible for people with anxiety or depression related disorders. Three per cent disagreed with this statement. Three per cent of respondents reported that they were unsure and one per cent did not respond.





June 2010

Q33. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People with substance use disorders.

Thirty four per cent of respondents agreed that Better Access had contributed to making health services more accessible for people with substance use disorders. Thirty per cent disagreed with this statement. Thirty three per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to services being more accessible for people with substance abuse disorders Respondents Per cent Strongly Agree 23 11% Agree 47 23% Unsure 68 33% Disagree 51 25% Strongly Disagree 11 5% Did not respond 3 1% Grand Total 203 100%




June 2010

Q34. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: Aboriginal and Torres Strait Islander people.

Twenty per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for Aboriginal and Torres Strait Islander people. Seventeen per cent disagreed with this statement. Sixty one per cent of respondents reported that they were unsure and two per cent did not respond to this question. This distribution of responses was broadly consistent across the regions although the two respondents from the remote regions disagreed or were unsure.

BAI has contributed to making mental health services more accessible for Aboriginal and Torres Strait Islander people Respondents Per cent Strongly Agree 10 5% Agree 30 15% Unsure 124 61% Disagree 20 10% Strongly Disagree 15 7% Did not respond 4 2% Grand Total 203 100%

Respondents BAI has contributed to making mental health

services more accessible for Aboriginal and Torres Strait Islander people

Major City

Inner Regional

Outer Regional Remote Total

Strongly Agree 6 0 2 0 8 Agree 17 8 0 0 25 Unsure 85 20 7 1 113 Disagree 14 3 3 0 20 Strongly Disagree 8 4 1 1 14 Did not respond 2 1 0 0 3 Grand Total 132 36 13 2 183




June 2010

Q 35. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People living in rural communities.

Twenty seven per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for people living in rural communities. Fourteen per cent disagreed with this statement. Fifty seven per cent of respondents reported that they were unsure and two per cent did not respond to this question. By region, the distribution of responses varied, with the majority of regional respondents agreeing with the statement while the majority of major city respondents were unsure.

BAI has contributed to making mental health services more accessible for people living in rural communities Respondents Per cent Strongly Agree 19 9% Agree 37 18% Unsure 115 57% Disagree 16 8% Strongly Disagree 12 6% Did not respond 4 2% Grand Total 203 100%


services more accessible for people living in rural communities

Major City

Inner Regional






June 2010

Q 36. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People living in remote communities.

Eleven per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for people living in remote communities. Sixteen per cent disagreed with this statement. Seventy one per cent of respondents reported that they were unsure and two per cent did not respond to this question. This distribution of responses was broadly consistent across the regions although the two respondents from the remote regions disagreed or were unsure.

BAI has contributed to making mental health services more accessible for people living in remote communities Respondents Per cent Strongly Agree 4 2% Agree 18 9% Unsure 144 71% Disagree 19 9% Strongly Disagree 14 7% Did not respond 4 2% Grand Total 203 100%


services more accessible for people living in remote communities

Major City

Inner Regional






June 2010

Q 37. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: People from culturally and linguistically diverse backgrounds.35

Twenty one per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making health services more accessible for people from culturally and linguistically diverse backgrounds. Sixteen per cent disagreed. Sixty per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for people from culturally and linguistically diverse backgrounds Respondents Per cent Strongly Agree 8 4% Agree 35 17% Unsure 122 60% Disagree 27 13% Strongly Disagree 7 3% Did not respond 4 2% Grand Total 203 100%

35 Note previous question 31 refers to Better Access Initiative contributing to more culturally and linguistically diverse mental health services Component D - June 2010- Report Appendices - revision 2906 (9278415) - 74



June 2010

Q 38. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: Children and young people.

Sixty five per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making mental health services more accessible for children and young people. Ten per cent disagreed. Twenty three per cent of respondents reported that they were unsure and two per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for children and young people Respondents Per cent Strongly Agree 46 23% Agree 86 42% Unsure 46 23% Disagree 14 7% Strongly Disagree 7 3% Did not respond 4 2% Grand Total 203 100%




June 2010

Q 39. To what extent do you agree with the following statement: the Better Access initiative has contributed to making mental health services more accessible for: Older people (i.e. those aged 65 + years).

Sixty five per cent of respondents agreed with the statement that the Better Access Initiative had contributed to making mental health services more accessible for older people. Ten per cent disagreed. Twenty three per cent of respondents reported that they were unsure and one per cent did not respond to this question.

BAI has contributed to making mental health services more accessible for older people Respondents Per cent Strongly Agree 47 23% Agree 85 42% Unsure 47 23% Disagree 16 8% Strongly Disagree 5 2% Did not respond 3 1% Grand Total 203 100%

Q 40. Additional comments

Feedback received through this question is included in the main body of the report and provided at the conclusion of this appendix.




June 2010

Q 41. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People with anxiety or depression related disorders.

Seventy nine per cent of respondents agreed with the statement that the Better Access Initiative had contributed to more appropriate services being provided to people with anxiety or depression related disorders. Two per cent of respondents disagreed. Five per cent were unsure and 13 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people with anxiety or depression related disorders Respondents Per cent Strongly Agree 75 37% Agree 85 42% Unsure 11 5% Disagree 3 1% Strongly Disagree 3 1% Did not respond 26 13% Grand Total 203 100%




June 2010

Q 42. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People with substance use disorders.

Twenty seven per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people with substance abuse disorders. Twenty per cent disagreed with this statement. Thirty nine per cent per cent of respondents unsure and 13 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people substance abuse disorders Respondents Per cent Strongly Agree 15 7% Agree 41 20% Unsure 79 39% Disagree 29 14% Strongly Disagree 12 6% Did not respond 27 13% Grand Total 203 100%




June 2010

Q 43. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: Aboriginal and Torres Strait Islander people.

Ten per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to Aboriginal and Torres Strait Islander people. Twelve per cent disagreed with this statement. Sixty four per cent of respondents were unsure and 13 per cent did not respond to this question. This distribution of responses was broadly consistent across the regions although the two respondents from the remote regions disagreed or were unsure.

BAI has contributed to more appropriate services being provided to Aboriginal and Torres Strait Islander people Respondents Per cent Strongly Agree 4 2% Agree 16 8% Unsure 130 64% Disagree 15 7% Strongly Disagree 11 5% Did not respond 27 13% Grand Total 203 100%

Respondents BAI has contributed to more appropriate services being provided to Aboriginal and Torres Strait Islander people

Major City

Inner Regional






June 2010

Q 44. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People living in rural communities.

Twenty per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people living in rural communities. Eight per cent disagreed with this statement. Fifty seven per cent of respondents were unsure and 14 per cent did not respond to this question. By region, the distribution of responses varied, with the majority of regional respondents agreeing with the statement while the majority of major city respondents were unsure.

BAI has contributed to more appropriate services being provided to people living in rural communities Number Per cent Strongly Agree 11 5% Agree 31 15% Unsure 115 57% Disagree 9 4% Strongly Disagree 9 4% Did not respond 28 14% Grand Total 203 100%

Respondents BAI has contributed to more appropriate

services being provided to people living in rural communities

Major City

Inner Regional






June 2010

Q 45. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People living in remote communities.

Ten per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people living in remote communities. Eleven per cent disagreed with this statement. Sixty six per cent of respondents were unsure and 13 per cent did not respond to this question. This distribution of responses was broadly consistent across the regions although the two respondents from the remote regions disagreed or were unsure.

BAI has contributed to more appropriate services being provided to people living in remote communities Respondents Per cent Strongly Agree 4 2% Agree 16 8% Unsure 133 66% Disagree 12 6% Strongly Disagree 11 5% Did not respond 27 13% Grand Total 203 100%

Respondents BAI has contributed to more appropriate

services being provided to people living in remote communities

Major City

Inner Regional






June 2010

Q 46. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: People from culturally and linguistically diverse backgrounds.

Eighteen per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to people from culturally and linguistically diverse backgrounds. Twelve per cent disagreed with this statement. Fifty five per cent of respondents were unsure and 14 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to people from culturally and linguistically diverse backgrounds Respondents Per cent Strongly Agree 7 3% Agree 31 15% Unsure 111 55% Disagree 17 8% Strongly Disagree 9 4% Did not respond 28 14% Grand Total 203 100%




June 2010

Q 47. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: Children and young people.

Fifty four per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to children and young people. Eight per cent disagreed with this statement. Twenty four per cent of respondents were unsure and 13 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to children and young people Respondents Per cent Strongly Agree 30 15% Agree 80 39% Unsure 48 24% Disagree 11 5% Strongly Disagree 7 3% Did not respond 27 13% Grand Total 203 100%

Q 48. To what extent do you agree with the following statement: the Better Access initiative has contributed to more appropriate services being provided to: Older people (i.e. those aged 65 + years).

Fifty three per cent of respondents agreed with the statement that the Better Access Initiative has contributed to more appropriate services being provided to older people. Eight per cent disagreed with this statement. Twenty five per cent of respondents were unsure and 14 per cent did not respond to this question.

BAI has contributed to more appropriate services being provided to older people Respondents Per cent Strongly Agree 37 18% Agree 71 35% Unsure 51 25% Disagree 10 5% Strongly Disagree 6 3% Did not respond 28 14% Grand Total 203 100%




June 2010

Q 49. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People with anxiety or depression related disorders.

Eighty one per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people with anxiety or depression related disorders. Two one per cent disagreed with this statement. Four per cent of respondents were unsure and 12 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people with anxiety or depression related disorders Respondents Per cent Strongly Agree 95 47% Agree 69 34% Unsure 9 4% Disagree 3 1% Strongly Disagree 3 1% Did not respond 24 12% Grand Total 203 100%




June 2010

Q 50. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People with substance use disorders.

Thirty five per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people with substance abuse disorders. Twenty two per cent disagreed with this statement. Thirty one per cent of respondents were unsure and 12 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people with substance abuse disorders Respondents Per cent Strongly Agree 22 11% Agree 49 24% Unsure 62 31% Disagree 36 18% Strongly Disagree 9 4% Did not respond 25 12% Grand Total 203 100%




June 2010

Q 51. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: Aboriginal and Torres Strait Islander people.

Ten per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for Aboriginal and Torres Strait Islander people. Thirteen per cent disagreed with this statement. Sixty four per cent of respondents were unsure and 12 per cent did not respond to this question. This distribution of responses was broadly consistent across the regions although the two respondents from the remote regions disagreed or were unsure.

BAI has contributed to improved mental health outcomes for Aboriginal and Torres Strait Islander people Respondents Per cent Strongly Agree 5 2% Agree 16 8% Unsure 129 64% Disagree 19 9% Strongly Disagree 9 4% Did not respond 25 12% Grand Total 5 100%

Respondents BAI has contributed to improved mental

health outcomes for Aboriginal and Torres Strait Islander people

Major City

Inner Regional






June 2010

Q 52. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People living in rural communities.

Twenty three per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people living in rural communities. Nine per cent of respondents disagreed with this statement. Fifty four per cent of respondents were unsure and 13 per cent did not respond to this question. By region, the distribution of responses varied, with the majority of regional respondents agreeing with the statement while the majority of major city respondents were unsure.

BAI has contributed to improved mental health outcomes for people living in rural communities. Respondents Per cent Strongly Agree 14 7% Agree 33 16% Unsure 110 54% Disagree 11 5% Strongly Disagree 9 4% Did not respond 26 13% Grand Total 203 100%


health outcomes for people living in rural communities.

Major City

Inner Regional






June 2010

Q 53. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People living in remote communities.

Nine per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people living in remote communities. Eleven per cent of respondents disagreed with this statement. Sixty seven per cent of respondents were unsure and 12 per cent did not respond to this question. This distribution of responses was broadly consistent across the regions although the two respondents from the remote regions disagreed or were unsure.

BAI has contributed to improved mental health outcomes for people living in remote communities. Respondents Per cent Strongly Agree 3 1% Agree 16 8% Unsure 137 67% Disagree 12 6% Strongly Disagree 10 5% Did not respond 25 12% Grand Total 203 100%


health outcomes for people living in remote communities.

Major City

Inner Regional






June 2010

Q 54. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: People from culturally and linguistically diverse backgrounds.

Eighteen per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for people from culturally and linguistically diverse backgrounds. Fourteen per cent of respondents disagreed with this statement. Fifty five per cent were unsure and 13 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for people from culturally and linguistically diverse backgrounds Respondents Per cent Strongly Agree 6 3% Agree 31 15% Unsure 111 55% Disagree 19 9% Strongly Disagree 10 5% Did not respond 26 13% Grand Total 203 100%

Q 55. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: Children and young people.

Fifty two per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for children and young people. Ten per cent of respondents disagreed with this statement. Twenty five per cent of respondents were unsure and 12 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for children and young people Respondents Per cent Strongly Agree 33 16% Agree 74 36% Unsure 50 25% Disagree 15 7% Strongly Disagree 6 3% Did not respond 25 12% Grand Total 203 100%





June 2010

90

Q 56. To what extent do you agree with the following statement: the Better Access initiative has contributed to improved mental health outcomes for: Older people (i.e. those aged 65 + years).

Fifty six per cent of respondents agreed with the statement that the Better Access Initiative has contributed to improved mental health outcomes for older people. Eight per cent of respondents disagreed with this statement. Twenty three per cent were unsure and 12 per cent did not respond to this question.

BAI has contributed to improved mental health outcomes for older people Respondents Per cent Strongly Agree 39 19% Agree 75 37% Unsure 47 23% Disagree 9 4% Strongly Disagree 8 4% Did not respond 25 12% Grand Total 203 100%



June 2010

4.3 Comments from survey of GPs and psychiatrists

4.3.1 Profile of GP respondents providing comment Of the 203 respondents to the survey, 88 (43 per cent) provided additional comments regarding the Better Access initiative. Of these respondents who also provided their postcode of primary practice (93 per cent), 34 per cent were from Victoria, 27 per cent from New South Wales, 21 per cent from Queensland and 18 per cent were from South Australia, Western Australia or Tasmania. Eighty nine per cent of respondents were located in a major city or inner regional area. The remaining 11 per cent were from outer regional or remote areas.

4.3.2 Comments received on survey Note: Comments that were not relevant to the project/survey have not been included.

General Practitioner, Major City, NSW The form of training is problematic: now, after years of undertaking the program in its previous form, you want me to go back to start and train again. Do you do this for specialists too, or is it only GPs who you demean so? (#23)

General Practitioner, Major City, NSW FPS accredited GPs cannot work in their own settings, but only in accredited practices. This is an inappropriate restriction, and a waste of their expertise, qualifications and experience. (#28)

General Practitioner Major City NSW A marvellous programme. integrates well with my group practice. Allows appropriate counselling of appropriate people, all benefit from access to clinical psychologists, no losses or failures. Major benefit, appropriate time to review and assess patients, (#30)

General Practitioner Major City NSW I treat homeless men only in my GP. Better access seems useful but in reality, most are unable to keep appointments, do not have the cognitive skills to allow treatments to be effective and forming a good therapeutic relationship takes years not sessions. (#58)

General Practitioner Major City NSW Don't stop it! It has revolutionised management of patients, making help more accessible especially financially. Most patients I have referred will need no more than the six sessions. A few long-term patients, eg with chronic depression or personality disorders, or . . . .(incomplete comment) (#63)

General Practitioner Major City NSW Need more training programmes for ongoing CPD. A lot of paper work associated with mental health plans etc. (#74)




June 2010

General Practitioner Major City NSW I think there are a lot of people billing the item number without really doing the work. I have had patients not even aware that the item number has been used, some see it as a 'cash cow'. (#84)

General Practitioner Major City NSW Generally a very good program but the benefit has not extended to access to psychiatrists. The frequency and quality of reporting feedback from psychologists is very poor. An improvement to the program would be a compulsion for psychologists to write back. (#93)

General Practitioner Major City NSW The Better Access Initiative has been the best thing that has happened in my time in medicine to enable those who need professional care with mental health problems to receive it. It has been brilliant!!!! . (#112)

General Practitioner Major City NSW I think it has been a positive initiative for my patients with mental health conditions. (#132)

General Practitioner Major City NSW Best initiative in a long time. It enables lower SES population access to high quality allied mental health care. However the state health system seems to have decreased its allied health providers which should not have been allowed unless the same state . . . .(incomplete comment) (#137)

General Practitioner Major City NSW I don’t believe that GPs need extra training for referring patients under Better Access initiative. (#142)

General Practitioner Major City NSW 1. gap payments by some psychologists make referrals prohibitive

2. has done nothing to aid psychiatry access in Newcastle

3. psychologists seem to use 12 visits from January to December each year whilst GPs have been told it was from the date of the mental health plan. (#161)

General Practitioner Major City NSW Receiving reports from allied health staff about the treatment/progress of patients is very poor!!! (#178)

General Practitioner Major City QLD The paperwork associated with the preparation of mental health care plans and reviews etc can detract with establishing a therapeutic relationship. (#36)

General Practitioner Major City QLD No benefit for my major psychiatric patients, schizophrenia etc as too expensive. (#44)

General Practitioner Major City QLD I have still found many socially disadvantaged people not able to afford professional counselling services - specialised mental health services - as a result of fees charged by psychologists and clinical psychologists above those subsidised by the government. (#85)




June 2010

General Practitioner Major City QLD Access to affordable psychology services was long overdue, and has been a God-send for my patients. It has made a massive improvement in the management of the mental health disorders in the patients I see." (#88)

General Practitioner Major City QLD Overall the program has been a huge success for my patients. I am no longer juggling their mental health problems while trying to care for their other health issues. I enjoy mental health care but the truth is it's better for patients to get some specialist care. (#97)

General Practitioner Major City QLD It is great that it is remunerating me for time spent with these patients, but it could be made simpler. Especially the 2710 could be replaced by a referral letter. In a situation where GP numbers are very limited, it greatly frees up my time to help other patients. (#129)

General Practitioner Major City QLD It is a pity we can't just diagnose a recognisable mental illness and then write a letter to the allied health professional we want the patient to see. Why all the forms and tick the box requirements? (#143)

General Practitioner Major City QLD The overall concept is good, ie. improve the access to counselling for groups of people who will benefit more from counselling than through a medical model psychiatric care. However, the implementation is the challenging part. (#159)

General Practitioner Major City QLD The formatting of the case notes is poor. As a level 2 provider of FPS, I have patients referred who have already had a 2710 by another GP but done inadequately and I can't be renumerated for doing one thoroughly.. (#160)

General Practitioner Major City QLD Quality of reporting back from allied health is truly dismal much of the time, skill of allied health professionals highly variable, costs of psychologists have soared with rebate access under Medicare. (#167)

General Practitioner Major City SA FPS-trained GPs should be recognized for what they carry around in their heads, not the chair they have to sit on to do the work - an accredited practice is not necessary. Some of us work at locations that would never get accredited, such as residential care. (#54)

General Practitioner Major City SA Better access initiative is well intentioned, but like most things has been misused. As a GP with many years experience and training in mental health issues, I resent referring my patients to a social worker or OT with a counselling degree, who has a large . . . .(incomplete comment) (#113)

General Practitioner Major City SA Better Access is great, is needed, but could be improved. For GPs, feedback from psychologists and psychiatrists is still below an expected standard, and this limits GPs from giving even better service and getting better results. (#127)




June 2010

General Practitioner Major City SA The financial incentives within MBS have meant more GPs are prepared to do mental health consults, but because the MBS benefits for allied health remain low, most patients cannot afford the (necessary) gaps the allied health need to charge to stay viable. (#193)

General Practitioner Major City VIC Simply: Better outcomes has improved access to affordable mental healthcare to those who don't really need it and could afford it anyway. (#4)

General Practitioner Major City VIC Include integrative medicine perspectives and approaches. Mind/Body/Energy Medicine. Consider the effectiveness, and cost efficiencies of some of the less 'mainstream' modalities, eg Meridian therapies, Emotional Freedom techniques, www.emofree.com (#21)

General Practitioner Major City VIC It was difficult to find a list of psychologists specialising in children, adolescent and drug and alcohol related issues. (#24)

General Practitioner Major City VIC An invaluable pathway for improving treatment options due to increased availability and decreased cost. (#45)

General Practitioner Major City VIC Many of the psychologists either do not write back or write very little - not good when it's part of the program that they feed back to the GP who then continues to manage the patient(s). (#47)

General Practitioner Major City VIC Mental health services are still difficult to access for the unemployed, those on low incomes and the elderly (especially those in residential aged care facilities) except in acute "crisis" situations - the gap fee after the Medicare rebate still precludes. (#61)

General Practitioner Major City VIC It has really helped people who previously would not have been able to afford counselling to get this vital source of treatment and support - a great scheme.(#69)

General Practitioner Major City VIC There has been significant leakage with the public assuming (and at times reporting they have been told by another provider) that they can get counselling for a variety of issues that are not defined mental health problems. (#75)

General Practitioner Major City VIC We need a more appropriate template for a mental health plan. It is too formal, doesn't include much of the information likely to be gained by the GP. It is totally focused on patient deficits rather than their strengths and competencies. (#83)

General Practitioner Major City VIC The availability of allied mental health at low cost has been an important assistance to already over stretched GPs in the management of these patients. (#86)




June 2010

General Practitioner Major City VIC The emphasis in BOMH is on allied health practitioners providing mental health services and those GPs who have provided or continue to provide focussed psychological strategies are poorly supported by government (Medicare) and the RACGP. (#89)

General Practitioner Major City VIC One of the frustrations as a GP is patients often come in when a mental health care plan needs to be done (ie needs minimum 30 minute appointment) having been told by the allied health professional "they just need a referral from their GP". (#90)

General Practitioner Major City VIC Referrals are overly bureaucratic requiring a specified format. Further training is an insult to already appropriately trained professionals. (#99)

General Practitioner Major City VIC Communication from allied health providers is mostly late, unhelpful and usually consists of a request for a further six visits with no justification or discrimination. (#101)

General Practitioner Major City VIC The reports I have received back have varied markedly from quite helpful to non existent. In my experience, psychiatrists with one or two exceptions have always been quite useless at writing to GPs and this has not changed. (#139)

General Practitioner Major City VIC Other than the preparation of an MH plan and review of such, other item numbers haven't been helpful to me. If anything they are restrictive. They make no provision for prolonged consults. Very hard to find (still) psychiatrists who will do long term counselling. (#146)

General Practitioner Major City VIC I have noted the costs of some psychological services have increased by a similar amount to the Medicare rebate, i.e., the out of pocket costs for patients have remained much the same. (#149)

General Practitioner Major City VIC I don't always perform a formal mental health plan on every mental health patient, hence I would like an item number that is a 2713, but for a level "D" consultation, not just a level "C". I am level 2 trained, but don't usually use the fps item numbers. (#165)

General Practitioner Major City VIC Better Access allowing referral to psychologists/social workers and OTs is unable to be used in patients residing in Aged Care facilities. All older people should have access to these services. One other issue is the cost including out of pocket expense (#168)

General Practitioner Major City VIC I feel that too often patients get sent to their GP for a "Medicare funded referral" suggested by the psychologist they were already seeing and paying for willingly. I feel there should be greater regulation so that people with greater financial need are . . .(incomplete comment) (#172)

General Practitioner Major City VIC Access to psychiatrists remained to be unaffordable to the majority of people with mental illness even with the introduction of Better Access Initiative. (#173)




June 2010

General Practitioner Major City VIC The Initiative has been tremendous for my patients. The Medicare requirements for reviews and new mental health care plans have proved to be quite difficult to understand. I have run into problems of not knowing what to do when a different GP has started. (#175)

General Practitioner Major City VIC This Initiative is the single most important factor that has changed my working life in the past five years. Prior to this, dealing with mental health problems was nothing short of a titanic struggle for the average busy GP. (#195)

General Practitioner Major City WA Many people referred have problems that are relatively minor and so block places for more severe cases. Still a significant shortage of psychiatric services for children. (#32)

General Practitioner Major City WA Caters to those who can afford the gap and who are easy to look after (those who attend appointments on time, not complex), for the more complex, they can't afford or are not really as welcomed by providers. A lot of money for a small group, but very popular. (#96)

General Practitioner Major City WA Would like easy access to a central registry of psychologists, their qualifications and special areas of interest. (#98)

General Practitioner Major City WA I am very pleased to be able at last to have accessible and affordable psychology services for my patients, and item numbers which reflect the content of my mental health consultations. I also suspect that the availability of psychology has decreased the . . . .(incomplete comment) (#171)

General Practitioner Major City WA Mostly accessed by the milder illness patients who can afford the gap. I am unsure that it has been helpful for those with severe illness who cannot work and cannot afford gaps of up to $50. (#191)

Psychiatrist Major City NSW Psychologists seem to be charging exorbitant fees and have just soaked up the Medicare rebate. It is very hard to find a bulkbilling psychologist. This program has improved access for the wealthy to a Medicare subsidy. What level of scrutiny is there. (#200)

Psychiatrist Major City SA My impression is that Better Access referrals to allied health professionals are for low morbidity problems. There seems little quality control in the treatment people receive from this wide variety of allied health professionals, who at times seem to us . . . .(incomplete comment) (#10)

General Practitioner Inner Regional NSW Having worked in small rural towns with NO access or very limited crisis only Mental Health access, the BAMH scheme has made outcomes and treatments less drug focused and more diverse leading to improved outcomes. It is an amazing initiative (#5)




June 2010

General Practitioner Inner Regional NSW The fee from providers has dramatically increased. As a result the gap is about the same now as it was prior to the program commencing. It seems to me all that one major result that has occurred is remuneration has increased for the psychologists. (#51)

General Practitioner Inner Regional NSW I worked in headspace where young people get to access a great variety of mental health support. I think it's great that there is Better Access for these people as for some of them a problem can be squashed or detected before it becomes a problem in their lives. (#55)

General Practitioner Inner Regional NSW The above aren't the questions relevant to me, and I think many GPs. The required referral pathway is too complex and time consuming, albeit adequately paid by Medicare rebate. Usually, the referral happens in reverse order, patients request one.(#70)

General Practitioner Inner Regional NSW I feel that if GP assesses patient as requiring psychological services then they should be able to refer without doing a mental Health Plan. I don't find that doing a health plan adds any benefit other than enabling patient to access Medicare benefits. (#72)

General Practitioner Inner Regional NSW There is still a great tendency for allied health professionals to say to patients 'just get a referral from your GP', including to those who do not qualify as having a mental disorder. This is either disingenuous of those allied health professionals or s. . . .(incomplete comment) (#94)

General Practitioner Inner Regional NSW Excellent items, easy to use, good communication 2 way between GP and psychologist. Good access for patient who can’t afford private fees to psychologists, enables people to get back to work by treating their mental health disorder. (#102)

General Practitioner Inner Regional QLD Empowering patients, self help strategy learning, less medication reliance, demystifying mental illness etc = huge benefits. affordability & distance options are brilliant too. (#145)

General Practitioner Inner Regional QLD I refer patients for short term psychological treatment as CBT. CBT is an evidence based very powerful technique to treat anxiety disorders and depression and I am very happy that Better Access made it available to a greater audience. (#154)

General Practitioner Inner Regional TAS Many providers are not trained adequately and their standards of practice are not ensured enough. Only those using proven therapies should be subsidised and only those properly trained e.g. clinical psychologists should have services subsidised. (#144)

General Practitioner Inner Regional VIC 1. I have never received clinical reports from psychologists. Why?




June 2010

2. I have no clear understanding of the professional skill and competence of the various psychologists in our region.

3. The Better Access Initiative does allow more affordable services b. . . .(incomplete comment) (#64)

General Practitioner Inner Regional VIC Better access would be a much better use of money and resources if access to psychologists etc could be direct or by a well written meaningful GP referral rather than a formulaic wordy not generally appropriate mental health plan that requires a long appointment time. (#95)

General Practitioner Inner Regional VIC l am pleased to continue to fund this initiative - cut the red tape and remove the mental health plan hurdle. (#204)

General Practitioner Inner Regional VIC The contribution of MH trained GPs (ie those eligible to provide focused psychological strategies) should be recognised as valuable and not overlooked because they as a group are numerically smaller than allied health professionals. (#205)

Psychiatrist Inner Regional TAS Ill-conceived, poorly monitored. (#11)

General Practitioner Outer Regional QLD Has not increased number of mental health providers in rural areas, especially in areas of Child/Youth Mental Health or Indigenous mental health. (#59)

General Practitioner Outer Regional QLD To build further upon this initiative. (#71)

General Practitioner Outer Regional QLD Great in terms of improving psychology access but no improvement at all in provision of psychiatrists. (#76)

General Practitioner Outer Regional QLD In our area, there are a limited number of Allied workers using languages other than English, and no-one with an ATSI background. The cost of the co-payment is prohibitive, leading to continued poor services to the poor and ATSI folk. (#124)

General Practitioner Outer Regional QLD A lot of patients don’t complete or come back for review. They consider it as just like any other referral. Reverse Referrals after a patient has seen a psychologist are very awkward and often inappropriate and should be actively discouraged. (#197)

General Practitioner Outer Regional SA Has greatly freed up my time as a rural GP to see more patients, as I'm not having to do as much counselling. Excellent scheme - well done Government. Could do lots more for inpatient mental health services though. (#38)

General Practitioner Outer Regional TAS I find that there is lack of mental health providers specialising in drug and alcohol services in our area. (#68)




June 2010

General Practitioner Outer Regional VIC Still limited numbers psychologists in the country. (#100)

General Practitioner Remote WA In principal it would have been great if one had enough psychologists and psychiatrists, paper access initiatives go no-where without these people actually existing. And they had not. (#49)

General Practitioner This is an excellent programme. This has not only made access to mental health a little bit easier but has also improved outcomes of mental health disorders. (#25)

General Practitioner 1. I am mental health level two trained. I need further specific training in my area to strengthen my CBT IPT skills and other skill but no such work shop is available for this triennium to sustain my mental health level 2. (#34)

General Practitioner Better access initiative has been a miracle - patients who could never afford counselling have been able to access services, would be good to have more salaried psychologists - as many still have a hefty gap which is difficult for disadvantaged to pay. (#106)

General Practitioner I don't think the outcomes are better over time, eg the number of patients who benefit from six sessions only from eg CBT is probably no better than the number of patients who get better anyway over time through regular contact with a GP like me who has a specialist mental health training. (#153)

General Practitioner I think the Medicare funding is excellent but do not feel there is a need for the complex GP item for referral. Referrals could be done just as appropriately with a "normal" referral letter like a GP does for any other referral (which would often be more). (#164)

Psychiatrist Most patients bypass psychiatrists altogether. Patients now receive poor quality care with poorly trained GPs and psychologists. Patients now have about 6 months more illness and accumulated complications before they get referred to a psychiatrist. (#9)




June 2010

5 Survey of public providers

5.1 Sampling Information on the evaluation and hyperlink to the online survey was distributed through the Departments responsible for public mental health services in each state or territory.



5.2 Responses to survey of public providers Q1. What best describes your role within your organisation?

Respondents comprised 179 Service providers, 40 Service director/team leaders, nine Administrative managers and one respondent who did not provide their occupation.

Occupation Respondents Per cent Administrative manager 9 4% Service director/team leader 40 17% Service provider 179 78% (blank) 1 0% Grand Total 229 100%

Q2. In which state/territory is your service based?

The most respondents (41 per cent) were from South Australia. Thirty three per cent of respondents were from New South Wales and 13 per cent of respondents came from the Australian Capital Territory whilst all other states and territories had less than 10 per cent of respondents each.




June 2010

State or Territory the respondent is based Respondents Per cent Australian Capital Territory 29 13% New South Wales 75 33% Northern Territory 4 2% Queensland 6 3% South Australia 93 41% Tasmania 1 0% Victoria 13 6% Western Australia 7 3% (blank) 1 0% Grand Total 229 100%

Q3. Where is most of your service provided?

The majority of respondents (63 per cent) provide most of their service in a metropolitan area. Eighteen per cent of respondents provide most of their service in a regional area and 10 per cent provide most of their service in a rural area, whilst all other areas had less than 10 per cent of respondents each. Two respondents did not provide an answer.

Area service is provided Respondents Per cent Metropolitan area 145 63% Regional area 41 18% Remote area 4 2% Rural area 24 10% Statewide 13 6% (blank) 2 1% Grand Total 229 100%

Q4. What is the primary client group of your organisation?

Out of the total 229 respondents, most (79 per cent) identified general adults as a primary client group of their organisation. Twenty three per cent identified adolescents as a primary client group. Nineteen per cent identified children as a primary client group whilst 28 per cent identified older people as a primary client group.

Client group Respondents

Per cent of total respondents

Children (0 to 12 years) 44 19% Adolescent/younger people (12 to 18 years) 52 23% General adult (18 to 64 years) 182 79% Older people (65 years and older) 42 18%





June 2010

102

Q5. How many staff are involved in direct client service delivery in your organisation?

Half of the respondent organisations have less than 20 staff involved in direct client service delivery, while a quarter have between 21 and 100 and a quarter have more than 100.

Staff involved in direct client service delivery Respondents Per cent Less than 10 60 26% Between 11 and 20 54 24% Between 21 and 50 39 17% Between 51 and 100 20 9% More than 100 54 24% (blank) 2 1% Grand Total 229 100%

Q6. Has the Better Access Initiative affected access to clinical training in your discipline?

The majority of respondents (81 per cent) indicated that the Better Access Initiative has not affected access to clinical training in their discipline. Only 19 per cent indicated that the Better Access Initiative had an effect.

BAI has affected access to clinical training Respondents Per cent Yes 43 19% No 185 81% (blank) 1 0% Grand Total 229 100%

Q6a. Has the Better Access Initiative affected access to clinical training in your discipline? If yes has it improved access or made it more difficult?

The majority of respondents (53 per cent) who indicated that the Better Access Initiative has affected access to clinical training in their discipline reported that it had improved access, while 42 per cent reported that it had made access more difficult.

BAI has affected access to clinical training Respondents Per cent Improved access 23 53% Made it more difficult 18 42% (blank) 2 5% Grand Total 43 100%



June 2010

Q 14. To what extent do you agree with the following statement: Workers within my organisation are aware of the services offered by Better Access.

Sixty three per cent agreed with the statement that workers within their organisation are aware of the services offered by Better Access. Eighteen per cent disagreed with this statement. Seventeen per cent were unsure and two per cent did not respond.

Workers within my organisation are aware of the services offered by Better Access. Respondents Per cent Strongly Agree 47 21% Agree 96 42% Unsure 40 17% Disagree 25 11% Strongly Disagree 16 7% Did not respond 5 2% Grand Total 229 100%

Respondents Workers within my organisation are aware of the services offered by Better Access Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 23 13 0 6 4 1 47 Agree 67 18 3 3 5 0 96 Unsure 25 6 0 8 1 0 40 Disagree 16 3 1 4 1 0 25 Strongly Disagree 12 1 0 1 2 0 16 Did not respond 2 0 0 2 0 1 5 Grand Total 145 41 4 24 13 2 229




June 2010

Q 15. To what extent do you agree with the following statement: Workers within my organisation know how to refer people to services available through Better Access.

Forty nine per cent agreed with the statement that workers within their organisation know how to refer people to services available through Better Access. Twenty one per cent disagreed with this statement. Twenty four per cent were unsure and six per cent did not respond.

Workers within my organisation know how to refer people to services available through Better Access. Respondents Per cent Strongly Agree 30 13% Agree 82 36% Unsure 54 24% Disagree 35 15% Strongly Disagree 14 6% Did not respond 14 6% Grand Total 229 100%

Respondents Workers within my organisation are aware of the services offered by Better Access Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 17 7 0 3 3 0 30 Agree 50 16 4 10 2 0 82 Unsure 32 11 0 4 6 1 54 Disagree 25 4 0 6 0 0 35 Strongly Disagree 11 1 0 0 2 0 14 Did not respond 10 2 0 1 0 1 14 Grand Total 145 41 4 24 13 2 229




June 2010

Q 16. To what extent do you agree with the following statement: Better Access has improved the mental health service system

Fifty seven per cent agreed with the statement that Better Access has improved the mental health service system. Seventeen per cent disagreed with this statement. Twenty seven per cent were unsure.

Better Access has improved the mental health service system Respondents Per cent Strongly Agree 43 19% Agree 86 38% Unsure 61 27% Disagree 25 11% Strongly Disagree 13 6% Did not respond 1 0% Grand Total 229 100%

Respondents Better Access has improved the mental health service system Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 23 13 0 2 5 0 43 Agree 54 14 1 12 4 1 86 Unsure 42 9 1 8 1 0 61 Disagree 16 4 1 2 2 0 25 Strongly Disagree 10 1 1 0 1 0 13 Did not respond 0 0 0 0 0 1 1 Grand Total 145 41 4 24 13 2 229




June 2010

Q 17. To what extent do you agree with the following statement: Better Access provides referral options for people contacting my organisation who we would not normally provide services to.

Fifty two per cent agreed with the statement that Better Access provides referral options for people contacting their organisation who they would not normally provide services to. Twenty five per cent disagreed with this statement. Twenty one per cent were unsure and two per cent did not respond.

Better Access provides referral options for people contacting my organisation who we would not normally provide services to. Respondents Per cent Strongly Agree 53 23% Agree 67 29% Unsure 49 21% Disagree 36 16% Strongly Disagree 20 9% Did not respond 4 2% Grand Total 229 100%

Respondents Better Access provides referral options for people contacting my organisation who we would not normally provide services to. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 30 14 1 4 4 0 53 Agree 44 8 1 10 3 1 67 Unsure 33 6 0 6 4 0 49 Disagree 19 10 1 4 2 0 36 Strongly Disagree 16 3 1 0 0 0 20 Did not respond 3 0 0 0 0 1 4 Grand Total 145 41 4 24 13 2 229




June 2010

Q 18. To what extent do you agree with the following statement: Better Access complements the services that my organisation provides.

Sixty five per cent agreed with the statement that Better Access complements the services that their organisation provides. Thirteen per cent disagreed with this statement. Twenty per cent were unsure and one per cent did not respond.

Better Access complements the services that my organisation provides Respondents Per cent Strongly Agree 65 28% Agree 85 37% Unsure 46 20% Disagree 19 8% Strongly Disagree 12 5% Did not respond 2 1% Grand Total 229 100%

Respondents Better Access complements the services that my organisation provides Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 38 18 0 5 4 0 65 Agree 54 13 1 14 2 1 85 Unsure 33 5 0 3 5 0 46 Disagree 11 3 2 1 2 0 19 Strongly Disagree 9 2 1 0 0 0 12 Did not respond 0 0 0 1 0 1 2 Grand Total 145 41 4 24 13 2 229




June 2010

Q 19. To what extent do you agree with the following statement: Better Access has reduced demand for the services that my organisation provides.

Twenty one per cent agreed with the statement that Better Access has reduced demand for the services that their organisation provides. Fifty one per cent disagreed with this statement. Twenty eight per cent were unsure and one per cent did not respond.

Better Access has reduced demand for the services that my organisation provides. Respondents Per cent Strongly Agree 18 8% Agree 29 13% Unsure 64 28% Disagree 68 30% Strongly Disagree 48 21% Did not respond 2 1% Grand Total 229 100%

Respondents Better Access has reduced demand for the services that my organisation provides. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 12 4 0 1 1 0 18 Agree 17 8 0 2 2 0 29 Unsure 36 10 1 13 3 1 64 Disagree 45 10 2 6 5 0 68 Strongly Disagree 34 9 1 2 2 0 48 Did not respond 1 0 0 0 0 1 2 Grand Total 145 41 4 24 13 2 229




June 2010

Q 20. To what extent do you agree with the following statement: Better Access has increased options for referral to mental health services for individuals using my service.

Sixty three per cent agreed with the statement that Better Access has increased options for referral to mental health services for individuals using their service. Eighteen per cent disagreed with this statement. Eighteen per cent were unsure.

Better Access has increased options for referral to mental health services for individuals using my service. Respondents Per cent Strongly Agree 48 21% Agree 97 42% Unsure 41 18% Disagree 26 11% Strongly Disagree 16 7% Did not respond 1 0% Grand Total 229 100%

Respondents Better Access has increased options for referral to mental health services for individuals using my service. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 29 10 0 5 3 1 48 Agree 62 18 1 12 4 0 97 Unsure 27 7 0 4 3 0 41 Disagree 15 5 2 1 3 0 26 Strongly Disagree 12 1 1 2 0 0 16 Did not respond 0 0 0 0 0 1 1 Grand Total 145 41 4 24 13 2 229




June 2010

Q 21. To what extent do you agree with the following statement: Better Access has had no real impact on the client group that my service works with.

Twenty six per cent agreed with the statement that Better Access has had no real impact on the client group that their service works with. Fifty three per cent disagreed with this statement. Nineteen per cent were unsure and two per cent did not respond.

Better Access has had no real impact on the client group that my service works with. Respondents Per cent Strongly Agree 15 7% Agree 44 19% Unsure 43 19% Disagree 81 35% Strongly Disagree 42 18% Did not respond 4 2% Grand Total 229 100%

Respondents Better Access has had no real impact on the client group that my service works with. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 11 2 0 1 1 0 15 Agree 28 9 2 4 1 0 44 Unsure 28 10 0 4 1 0 43 Disagree 51 13 0 10 6 1 81 Strongly Disagree 25 7 1 5 4 0 42 Did not respond 2 0 1 0 0 1 4 Grand Total 145 41 4 24 13 2 229




June 2010

Q 22. To what extent do you agree with the following statement: My service receives many referrals from Better Access providers.

Twenty per cent agreed with the statement that their service receives many referrals from Better Access providers. Sixty per cent disagreed with this statement. Nineteen per cent were unsure and one per cent did not respond.

My service receives many referrals from Better Access providers. Respondents Per cent Strongly Agree 10 4% Agree 36 16% Unsure 44 19% Disagree 66 29% Strongly Disagree 70 31% Did not respond 3 1% Grand Total 229 100%

Respondents My service receives many referrals from Better Access providers. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 6 2 1 1 0 0 10 Agree 23 9 0 2 2 0 36 Unsure 26 9 0 8 1 0 44 Disagree 42 10 2 5 6 1 66 Strongly Disagree 46 11 1 8 4 0 70 Did not respond 2 0 0 0 0 1 3 Grand Total 145 41 4 24 13 2 229




June 2010

Q 23. To what extent do you agree with the following statement: My service encourages many patients to contact their GP to request a referral to allied health services through Better Access.

Fifty four per cent agreed with the statement that their service encourages many patients to contact their GP to request a referral to allied health services through Better Access. Twenty two per cent disagreed with this statement. Twenty three per cent were unsure and one per cent did not respond.

My service encourages many patients to contact their GP to request a referral to allied health services through Better Access. Respondents Per cent Strongly Agree 40 17% Agree 84 37% Unsure 52 23% Disagree 34 15% Strongly Disagree 16 7% Did not respond 3 1% Grand Total 229 100%

Respondents My service encourages many patients to contact their GP to request a referral to allied health services through Better Access. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 24 9 1 3 2 1 40 Agree 57 12 2 8 5 0 84 Unsure 34 8 1 7 2 0 52 Disagree 17 11 0 3 3 0 34 Strongly Disagree 11 1 0 3 1 0 16 Did not respond 2 0 0 0 0 1 3 Grand Total 145 41 4 24 13 2 229




June 2010

Q 24. To what extent do you agree with the following statement: Better Access providers work well with my service to provide coordinated care to clients using both services.

Thirty per cent agreed with the statement that Better Access providers work well with their service to provide coordinated care to clients using both services. Forty per cent disagreed with this statement. Twenty eight per cent were unsure and one per cent did not respond.

Better Access providers work well with my service to provide coordinated care to clients using both services. Respondents Per cent Strongly Agree 21 9% Agree 49 21% Unsure 65 28% Disagree 60 26% Strongly Disagree 32 14% Did not respond 2 1% Grand Total 229 100%

Respondents Better Access providers work well with my service to provide coordinated care to clients using both services. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 11 6 0 1 2 1 11 Agree 26 12 0 8 3 0 26 Unsure 47 9 1 6 2 0 47 Disagree 37 11 2 6 4 0 37 Strongly Disagree 23 3 1 3 2 0 23 Did not respond 1 0 0 0 0 1 1 Grand Total 145 41 4 24 13 2 229




June 2010

Q 25. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain occupational therapists.

Six per cent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain occupational therapists. Thirty eight per cent disagreed with this statement. Fifty one per cent were unsure and five per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain occupational therapists. Respondents Per cent Strongly Agree 5 2% Agree 9 4% Unsure 117 51% Disagree 45 20% Strongly Disagree 41 18% Did not respond 12 5% Grand Total 229 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain occupational therapists. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 4 0 0 1 0 0 5 Agree 7 2 0 0 0 0 9 Unsure 75 22 1 13 6 0 117 Disagree 29 9 2 2 3 0 45 Strongly Disagree 24 7 1 6 2 1 41 Did not respond 6 1 0 2 2 1 12 Grand Total 145 41 4 24 13 2 229




June 2010

Q 26. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain psychiatrists.

Six per cent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain psychiatrists. Forty four per cent disagreed with this statement. Forty five per cent were unsure and five per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain psychiatrists. Respondents Per cent Strongly Agree 7 3% Agree 6 3% Unsure 103 45% Disagree 53 23% Strongly Disagree 48 21% Did not respond 12 5% Grand Total 229 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain psychiatrists. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 4 1 1 1 0 0 7 Agree 4 1 0 1 0 0 6 Unsure 65 21 0 12 5 0 103 Disagree 34 11 2 3 3 0 53 Strongly Disagree 32 6 1 5 3 1 48 Did not respond 6 1 0 2 2 1 12 Grand Total 145 41 4 24 13 2 229




June 2010

Q 27. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain psychologists.

Thirty three per cent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain psychologists. Thirty three per cent disagreed with this statement. Thirty per cent were unsure and four per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain psychologists. Respondents Per cent Strongly Agree 37 16% Agree 39 17% Unsure 68 30% Disagree 38 17% Strongly Disagree 37 16% Did not respond 10 4% Grand Total 229 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain psychologists. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 23 7 1 5 1 0 37 Agree 26 5 0 4 4 0 39 Unsure 45 12 0 8 3 0 68 Disagree 23 10 2 1 2 0 38 Strongly Disagree 23 6 1 4 2 1 37 Did not respond 5 1 0 2 1 1 10 Grand Total 145 41 4 24 13 2 229




June 2010

Q 28. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain social workers.

Six per cent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain social workers. Forty two per cent disagreed with this statement. Forty eight per cent were unsure and five per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain social workers. Respondents Per cent Strongly Agree 4 2% Agree 9 4% Unsure 109 48% Disagree 52 23% Strongly Disagree 43 19% Did not respond 12 5% Grand Total 229 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain social workers. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 3 0 1 0 0 0 4 Agree 5 3 0 1 0 0 9 Unsure 73 18 0 14 4 0 109 Disagree 31 12 2 4 3 0 52 Strongly Disagree 28 7 1 3 3 1 43 Did not respond 5 1 0 2 3 1 12 Grand Total 145 41 4 24 13 2 229





June 2010

118

Q 29. To what extent do you agree with the following statement: Better Access has increased training and professional development opportunities for my staff.

Ten per cent agreed with the statement that Better Access has increased training and professional development opportunities for their staff. Fifty eight per cent disagreed with this statement. Twenty eight per cent were unsure and four per cent did not respond.

Better Access has increased training and professional development opportunities for my staff. Respondents Per cent Strongly Agree 4 2% Agree 18 8% Unsure 65 28% Disagree 80 35% Strongly Disagree 52 23% Did not respond 10 4% Grand Total 229 100%

Respondents Better Access has increased training and professional development opportunities for my staff. Metropolitan Regional Remote Rural Statewide (blank) Total Strongly Agree 4 0 0 0 0 0 4 Agree 11 0 1 4 2 0 18 Unsure 41 16 0 5 3 0 65 Disagree 51 15 2 5 6 1 80 Strongly Disagree 33 9 1 8 1 0 52 Did not respond 5 1 0 2 1 1 10 Grand Total 145 41 4 24 13 2 229



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5.3 Comments from survey of public providers

5.3.1 Profile of public provider respondents providing comment

Of the 229 respondents to the survey, 105 (46 per cent) provided additional comments regarding the Better Access initiative. Of these respondents, 39 per cent were from South Australia, 32 per cent from New South Wales, nine and eight per cent from ACT and Victoria, respectively, and 13 per cent from Queensland, Western Australia or Northern Territory. Sixty six per cent of respondents provided a metropolitan based service, 17 per cent provided a regional based service, 11 per cent provided a remote or rural area based service, six per cent provided a statewide service and 1 provider did not identify an area.

5.3.2 Comments received on survey

Statewide service -NSW I believe that the Better Access Initiative has had a markedly positive impact on the provision of mental health services. It has given clients greater access and choice for services that previously would have been unaffordable. (#36)

Statewide service -NSW Better Access has improved and increased the follow-up options for families, metropolitan and rural, who are treated and assessed at out service. (#46)

Statewide service -NT It has had very little impact here - any initiative based on GP service will struggle to make an impression beyond urban areas, and beyond those able to pay (and wait) to access GP services. The initiative does not really address the issues of recruitment. (#19)

Statewide service - SA Better Access has substantially decreased the number of "soft" referrals, however as a specialist MH service, it has correspondingly increased (on average) the acuity of the client referrals we see. BA providers generally do not have the facilities or training (#194)

Statewide service - SA Better access could be improved in the rural and remote area based services of SA by ensuring that the clinicians employed bring skills that are most needed for the area, that the areas targeted for funding are the ones that Country Health SA identify as high need. (#150)

Statewide service - SA Because Better Access emphasises allied health interventions to consumers with predominantly high prevalence disorders, it has little or no impact for people who are




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experiencing acute distress. This illustrates the need to fund mental health services. (#122)

Metropolitan based service - ACT Would be good if psychiatrists and psychiatry registrars working in the public system could refer to psychologists for treatment under this scheme. (#8)

Metropolitan based service - ACT When I worked in rural NSW in Mental Health where services are limited we referred onto the Better Access service all the time. In the ACT I hardly hear of it happening even though I think it is a good service. (#5)

Metropolitan based service - ACT Provision needs to be made to provide more sessions to more difficult and complex clients. (#160)

Metropolitan based service - ACT I would like to receive information about the initiative please. (#15)

Metropolitan based service - ACT I think the cost to the client to go to a GP and set up a plan is very high and should be claimable by the GP without up-front cost to the consumer, at least not above the usual GP visit cost. The program also doesn't cover neuropsychology. (#18)

Metropolitan based service - ACT 1. Why are Mental Health Nurses restricted from providing services as part of the Better Access Initiative? How are (e.g.) OTs better placed to provide such a Service?

2. Have you started to measure the actual outcomes for the Better Access Initiative? (#161)

Metropolitan based service - NSW There are ongoing problems working across systems, with differing expectations of what other systems/services can or should do. The experience and ability of private psychologists working within the Better Access scheme varies. (#41)

Metropolitan based service - NSW The restriction of Better Access to 12 sessions, or 18 in exceptional circumstances, and to CBT or IPT, makes it virtually useless for one of my client groups, adult survivors of childhood abuse, who typically need long term therapy. (#76)

Metropolitan based service - NSW The opportunity given to allied Health providers has been valued dearly by mental health clients. They not only provide psychological therapy but also providing them with psycho-education helps these clients and their carers in how to control their disorder.. (#212)

Metropolitan based service - NSW The initiative has not been effectively promoted, nor taken up, by my organisation. Lack of knowledge and awareness are barriers to drawing on the clear benefits the initiative provides. (#59)

Metropolitan based service - NSW The Better Access initiative is a much needed program that has allowed many people who would have previously fallen through the net of health services to access ongoing




June 2010

mental health support. Working within the government sector, this has not made a great change. (#52)

Metropolitan based service - NSW Senior management in public mental health services seem to have the opinion that they can move towards using Better Access to fund psychology services within the public mental health service, and therefore not need to employ or fund psychology services. (#71)

Metropolitan based service - NSW Private services are generally poorly coordinated with public sector C&A Mental Health services. Our service has experienced dumping of clients to public health when single providers go on holidays or if the clients become service intensive. (#27)

Metropolitan based service - NSW Patients get referred to us after running out of the Better Access sessions and there isn't always good communication. At times, Better Access is being used by those who were and can afford private treatment. (#77)

Metropolitan based service - NSW My primary concern would be that the BAI represents a privatisation of mental health care and that it has the impact of drawing resources away from the public mental health system which is often left to assess and treat the most severe mental health presentations. (#51)

Metropolitan based service - NSW It is really valuable to be able to offer patients and carers access to services closer to home, or that might give them a more secure sense of privacy (compared with the file entries in a hospital medical file). (#70)

Metropolitan based service - NSW It is imperative that the practitioners actually have specialised training in therapy as opposed to only psychological diagnosis and provision of advice or the extremely narrow and limited CBT. Many clinical psychologists do not have any specialised training. (#62)

Metropolitan based service - NSW Initially Better Access was a fantastic resource for our clients who are all students and mostly can't afford private treatment. However, increasingly there are very few who bulk bill and once again we are finding that students can't afford the gap fee payment. (#187)

Metropolitan based service - NSW I think it is a fantastic scheme. Whilst it does not directly relate to my clients, brain injured individuals, it has provided opportunities for referrals for their family members who may not have been eligible for ongoing psychological or social work support. (#175)

Metropolitan based service - NSW I have a particular concern regarding access of older people to these initiatives, and the training of participating clinicians in providing care to older people, particularly the 'frail' elderly or those with comorbid cognitive impairment. (#24)




June 2010

Metropolitan based service - NSW I am a GP accredited to provide FPS services within an AMS setting. There are very few opportunities for professional development for people like me who have completed post-graduate studies in psychology, but also have a medical degree. (#57)

Metropolitan based service - NSW Has increased number of part-time employees in the service, as some staff choose to work part-time under Better Access and part-time under the health service. I have been concerned at inexperience of some staff who operate under Better Access. (#107)

Metropolitan based service - NSW Due to the unofficial employment freeze we are unable recruit staff at all. The other issue is our clients are complex and require more than 12/18 sessions which is what they get under Better Access. The clients are then referred back to mainstream mental health services. (#177)

Metropolitan based service - NSW Better Access system does not include rebates for neuropsychological assessment for the purpose of differential diagnosis of dementia. This is a significant gap in terms of effective provision of services for behavioural and cognitive aspects of ageing. (#66)

Metropolitan based service - NSW Better Access Initiative is biased towards promoting business to just Psychologists, not to better qualified Clinical Psychologists and GPs trained to provide better services than just a psychologist with no other knowledge apart from CBT training! (#58)

Metropolitan based service - NSW Almost all clients who are referred from our service to the Better Access initiative are in need of "psychological therapy services" (provided by clinical psychologists) rather than the "focused psychological strategies" that a psychologist, social worker or occupational therapist provides. (#38)

Metropolitan based service - NSW Access to neuropsychological assessments would be a significant improvement in managing those with cognitive impairments and assisting in differential diagnosis (e.g. between psychological/psychiatric disorder and underlying organic change). (#72)

Metropolitan based service - NT It has offered both training for staff through the Division of General Practice and served to provide service delivery to clients who fall through the gaps in the public system. (#125)

Metropolitan based service - QLD Only that the 2 tiered level for psychologists means that I try to ensure I only refer patients to clinical psychologists and only to people I would recommend. Several psychologists attached to GPs in this state are not post graduate holders and in my view not that skilled. (#133)

Metropolitan based service - QLD I have not accessed the community provided training as yet, but have listed for this and will be commencing a link up to a community group this period. (#221)




June 2010

Metropolitan based service - QLD I am a registered general Psychologist (nearing the completion of a professional doctorate of clinical psychology) and I believe the Better Access initiative has been the best change to the mental health treatment available for the entire population. (#218)

Metropolitan based service - SA What is this thing called Better Access? (#121)

Metropolitan based service - SA This program has significant benefits for my clients and for me personally as it increases the care choices available to clients and what I can offer them following an assessment. (#126)

Metropolitan based service - SA Should include questions about barriers to access. Like the increasing gap payments. Therefore this initiative is not serving people in the low socio economic population who most need the service. (#99)

Metropolitan based service - SA Psychology services often of poor quality especially when provided by psychologists who are not trained as clinical psychologists. People can be referred for CBT and only get relaxation/supportive therapy. (#136)

Metropolitan based service - SA Our work establishment would benefit from an in-service as not all staff are aware of the Better Access service. (#147)

Metropolitan based service - SA Our service primarily assists clients with moderate to severe mental health issues, and often those with comorbid diagnoses, and for this reason, there is often minimal overlap with private practitioners using the Better Access initiative. (#86)

Metropolitan based service - SA Not inclusive of all allied health disciplines to be providers. Providers still charging gap fee which prohibits access for the socially disadvantaged. No requirement for providers to deliver evidence based interventions and or evidence of treatment outcomes. (#182)

Metropolitan based service - SA Need ongoing education of availability of services and referral process. Further workshop/presentations to Mental Health sites would be useful to update knowledge and awareness of service. (#201)

Metropolitan based service - SA My main role is as discipline Sen Psychologist in public mental health. I also work privately, mostly in response to GP Medicare referrals. It has become harder to attract and retain psychologists in the public system. (#127)

Metropolitan based service - SA It is very important to note that the Better Access scheme allows psychologists to charge HUGE gaps to patients in excess of the rebated amount (often up to $100 per session). The majority of patients referred to the Better Access scheme are unable to pay. (#138)




June 2010

Metropolitan based service - SA It is good to have alternatives for consumers. (#185)

Metropolitan based service - SA If Addiction Medicine is recognised as a specialty, Fellows of the Australasian Chapter of Addiction Medicine should be able to refer to s/w, OT and psychologists in the same way that psychiatrists and paediatricians can currently. (#156)

Metropolitan based service - SA I think the nomenclature or labelling of the various schemes need to be clearer and reflect the referral pathways for GP initiated/Medicare funded mental health care. The terms "Better Outcomes" or "Better Access" have little meaning to consumers or other. . .(incomplete comment) (#173)

Metropolitan based service - SA I recently had a session about Better Access - prior to that I had no idea allied health other than psychologists were accessible through this program - nor did others in my service (#91)

Metropolitan based service - SA I have many concerns about services provided by psychologists - many are inexperienced in dealing with significant mental health problems, and at best do nothing apart from provide no more than friendship and a bit of support, but often do significant harm (#88)

Metropolitan based service - SA I do not know a great deal about the Better Access initiative (#131)

Metropolitan based service - SA I am aware of the service we do refer patients to their GP for on going referral. I am not aware of any recruitment difficulties as this is not my responsibility (#219)

Metropolitan based service - SA Great idea to reduce need for emergency mental health services. Concerned re. amount of gap charged by most psychologists - few seem to bulk bill. I think a certain proportion of clients should be bulk billed. Great to refer but not sure how skilled the. . . .(incomplete comment) (#157)

Metropolitan based service - SA GPs now preferentially refer patients to allied health staff under Better Access, usually psychologists, who would previously have referred to our service for therapy. This has significantly reduced the numbers of clients for trainees to treat under supervision. (#228)

Metropolitan based service - SA Good initiative but is focussed really on individuals with less serious mental health conditions. However it does provide an early intervention and hopefully increases possibility of prevention of longer term conditions. (#85)

Metropolitan based service - SA Excellent way to provide access to vital psychologists who bulk bill. (#222)

Metropolitan based service - SA Better Access is not well known about. (#152)




June 2010

Metropolitan based service - SA Better Access initiative needs to provide more financial incentive for allied health workers to take on patients. Currently the system does not allow financial reimbursement for preparing reports, travel to patient's home etc. (#193)

Metropolitan based service - SA Better Access has been an essential complement to public mental health services that are chronically under resourced and struggling with demand. Better Access enables clients to access a broader range of services, with much greater continuity of care. (#178)

Metropolitan based service - SA As a psychiatrist, it has been helpful to use psychologists to undertake CBT rather than having to do it all myself. However, I am also seeing a number of patients who have seen psychologists first but are not much improved and they still end up seeing me. (#174)

Metropolitan based service - SA A valuable service for all of the community. (#171)

Metropolitan based service - VIC The Better Access initiative has taken funding from the public system but does not adequately support the private system so complicated cases are referred back to a system with fewer resources. (#110)

Metropolitan based service - VIC More information/media needs to be provided to the general public about the benefits of Better Access services. (#139)

Metropolitan based service - VIC It is one of the few initiatives that actually works (ie. to provide comprehensive, coordinated care for many of my mental health patients who would otherwise fall through the cracks). It is disappointing though to see that there are some unscrupulous GPs w. . . .(incomplete comment) (#63)

Metropolitan based service - VIC It is a valuable and much needed service. However, more promotion, better pay rates are needed to retain psychologists in public practice as this is a valuable forum for clinical training for students. (#162)

Metropolitan based service - VIC I think the initiative is very helpful for people with a mental health disorder. I also think that when the child is the client that when the parent comes alone they should be able to claim Medicare given that with young children what is in their best interest. (#129)

Metropolitan based service - VIC I believe that having doctors do a care plan and make a referral to allied health professionals has a very positive impact on their patients. They become more empowered and inclined to take responsibility for their own health and to implement and maintain. . . .(incomplete comment) (#118)




June 2010

Metropolitan based service - VIC 1. There was no required trial demonstration phase for BA, thoroughly evaluated with recognised clinical measures, hence it is not possible to reply to your question on "Impact". The question is redundant in the absence of such data. (#179)

Metropolitan based service - WA The BAMH initiative has allowed people that would not normally be able to afford mental health services to access these services. Further, it has had significant flow-on effects in terms of reducing the stigma of mental health, encouraging discussion of m. . . .(incomplete comment) (#191)

Regional area based service - ACT All of our service recommends consumers see their doctor and that they should use the Better Access Initiative. (#22)

Regional area based service - NSW This is a great initiative. As a public sector clinical psychologist, it is fantastic that clients have the option to access private psychology services in the community. This reduces the burden on our service and allows us to treat clients who are more. . . .(incomplete comment) (#49)

Regional area based service - NSW Not sure what Better Access is. (#33)

Regional area based service - NSW My understanding is that the initiative assists with more low level client concerns rather than complex cases. In our service, we need to consult with many other services including DOCS, and schools including meetings at those sights. (#209)

Regional area based service - NSW Mental health's role seems to increasingly be the management of the chronically mentally ill. This cohort is clogging up case managers whose numbers have not changed in my service for 10 years in an area whose population doubles every 10 years.(#53)

Regional area based service - NSW I believe the Initiative has made psychological support available to a large group of people who have had to go without in the past. (#75)

Regional area based service - NSW I am a psychologist with NSW Department of Corrective Services and we use this initiative with many of our clients. Psychologists providing this service usually do not seek information regarding their clients’ previous assessment and contact history. (#120)

Regional area based service - NSW Better Access does not increase mental health clients’ access to services in any meaningful way. Rather, the initiative provides funding for clients with mild difficulties; clients with moderate to severe mental health issues require more than 12-18 sessions. (#60)




June 2010

Regional area based service - NSW As someone who has newly entered the workforce as a psychologist, I'm very aware of the turmoil the Better Access initiative has created for psychologists around the two tiered system. I feel that this is a major issue. (#168)

Regional area based service - QLD The process of developing the plan and gaining the referral through the GP is often off-putting for clients which negatively affects a decision to access the initiative. (#155)

Regional area based service - QLD As an organisation, my understanding is that clients are not able to utilise the Better Access service if they come to my organisation for services, as the Better Access program only works for those individuals receiving and providing services in private practice. (#227)

Regional area based service - QLD A social worker having the mental health accreditation does not mean that this SW is actually working within the capacity of Better Access, as there is still a lot of prejudice to overcome from doctors and nurses, particularly in rural and Regional areas. (#205)

Regional area based service - SA We are able to refer clients with more straightforward issues that don't require a lot of interagency follow up through to Better Access and this appears to have somewhat reduced our waiting times. These are now building back to previous levels, and we are. . . .(incomplete comment) (#103)

Regional area based service - SA Visiting, sessional psychologists have long waiting lists in my Regional area based service. Psychiatrists do not want to work in the Regional area based service. They need a better remunerative incentive. Local doctors need more specialist mental health training. (#226)

Regional area based service - SA Often not able to give services to more remote areas. (#180)

Regional area based service - SA Experienced (Counselling, Clinical and PHC expertise) Mental Health Nurses should be included in the Better Access initiative in the regional/rural sector as they remain the most accessible resource for local GPs. (#208)

Regional area based service - VIC No comments in relation to the initiative but the survey was restricted by the fact it does not accommodate practitioners of psych or social work who work in both the private and government. sectors. Many have two jobs across both areas. (#197)

Regional area based service - WA Why is it that my services are paid less than that of a psych? We provide the same service. The program has and helps many people to access services in Rural area based services. (#211)

Remote area based service - NSW Better Access has reinforced a schism between public MH services and the GP population. Patients are being given care plans by their GPs and being told to withdraw




June 2010

from public MH services. We end up picking them up months later after there has been no re. . . .(incomplete comment) (#100)

Remote area based service - NT There are few service providers in regional NT, therefore the impact of such initiatives is greatly reduced, even though the idea is a good one. (#67)

Remote area based service - NT Other service providers in this area are thin on the ground so most of the disagrees are related to lack of (consistent on the ground, not a visit from the nearest large town every two weeks to a month) (#25)

Rural area based service - NSW Better Access providers are not able to service the kind of complex multi issue client typically seen by MH services. Funding used in Better Access Initiatives would be better spent supporting public health. (#28)

Rural area based service - SA There is a need for more psychology sessions especially for the older person in rural and remote SA. The CMHTs are not funded to case manage people over 65 years of age and many older people with depression and anxiety benefit from psychological therapy. (#141)

Rural area based service - SA New employee. Limited understanding. (#223)

Rural area based service - SA It is very useful and provides an alternative for consumers who do not meet community mental health team criteria. (#190)

Rural area based service - SA I have encouraged some parents who are in need of mental health services to ask their GP for a referral via Better Access. At times I have heard back that GPs have refused this, or not known about the initiative. (#169)

Rural area based service - SA I believe the Better Access initiative has meant parents of children/adolescents that we see can access support/counselling for themselves, which would previously have been unavailable. This has important positive implications for our work with children. (#84)

Rural area based service - VIC Young people and their parents had more limited opportunities within a Rural area based service - to gain access to allied health services. The Commonwealth initiative have improved the mental health outcomes of a range of families within more isolated regions. (#128)

Rural area based service - WA I cannot access any of the Better Access initiatives for my patients because I work in a state salaried position out of a hospital. We do not bill Medicare and can't utilise mental health care plans. (#159)

Area not identified - SA Waiting period for access to therapist if often an issue. (#163)




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June 2010

6 Survey of NGOs

6.1 Sampling Information on the evaluation and hyperlink to the online survey was distributed through peak mental health NGO organisations in each state or territory.



Q1. What best describes the purpose of your organisation?

For the majority of respondents (58 per cent), the purpose of their organisation was to provide direct mental health services. Eight respondents indicated that consumer and advocacy and support was their main purpose and eight indicated support and information to carers. Two respondents reported information and referral services was their purpose, one reported peak and one did not provide a purpose.

Purpose of organisation Respondents Per cent Consumer advocacy and support 8 17% Direct mental health service provision 28 58% Information and referral services 2 4% Peak 1 2% Support and information to carers 8 17% (blank) 1 2% Grand Total 48 100%

Q2. What best describes your role within your organisation?

Respondents comprised 11 Service providers, 32 Service director/team leaders, four Administrative managers and one respondent who did not provide their occupation.

Occupation Respondents Per cent Administrative manager 4 8% Service director / team leader 32 67% Service provider 11 23% (blank) 1 2% Grand Total 48 100%




June 2010

Q3. In which state/territory is your service based?

The majority of respondents (71 per cent) were from New South Wales. Seventeen per cent of respondents were from Western Australia, whilst all other states and territories excluding the Australian Capital Territory (no respondents) had less than five per cent of respondents each. One respondent did not provide the state or territory where their service is based

State or Territory the respondent is based Respondents Per cent New South Wales 34 71% Northern Territory 1 2% Queensland 1 2% South Australia 1 2% Victoria 2 4% Western Australia 8 17% (blank) 1 2% Grand Total 48 100%

Q4. Where is most of your service provided?

The majority of respondents (33 per cent) provide most of their service in a metropolitan area. Twenty three per cent of respondents provide most of their service in a regional area and 13 per cent provide most of their service in a rural area. Twenty five per cent of respondents provide their services statewide whilst 6 per cent provide their service in a remote area.

Area service is provided Respondents Per cent Metropolitan area 16 33% Regional area 11 23% Remote area 3 6% Rural area 6 13% Statewide 12 25% Grand Total 48 100%





June 2010

132

Q5. What is the primary client group of your organisation?

Out of the total 48 respondents, more than 90 per cent identified general adults as the primary client group of their organisation. Thirteen per cent identified adolescents, eight per cent identified children and 7 per cent identified older people.

Client group Respondents

Per cent of total

respondents Children (0 to 12 years) 4 8% Adolescent/younger people (12 to 18 years) 6 13% General adult (18 to 64 years) 44 92% Older people (65 years and older) 8 17%

Q6. How many staff are involved in direct client service delivery in your organisation?

The majority (65 per cent) of the respondents’ organisations have less than 20 staff involved in direct client service delivery. Fifteen per cent have between 21 and 50 staff and four per cent have between 51 and 100 staff. Seventeen per cent of respondents have more than 100 staff involved in client service delivery.

Staff involved in direct client service delivery Respondents Per cent Less than 10 22 46% Between 11 and 20 9 19% Between 21 and 50 7 15% Between 51 and 100 2 4% More than 100 8 17% Grand Total 48 100%



June 2010

Q 14. To what extent do you agree with the following statement: Workers within my organisation are aware of the services offered by Better Access.

Thirty nine per cent agreed with the statement that workers within their organisation are aware of the services offered by Better Access. Thirty six per cent disagreed with this statement. Twenty one per cent were unsure and four per cent did not respond.

Workers within my organisation are aware of the services offered by Better Access. Respondents Per cent Strongly Agree 5 10% Agree 14 29% Unsure 10 21% Disagree 8 17% Strongly Disagree 9 19% Did not respond 2 4% Grand Total 48 100%

Respondents Workers within my organisation are aware of the services offered by Better Access. Metropolitan Remote Rural Regional Statewide Total Strongly Agree 3 1 0 0 1 5 Agree 4 3 0 2 5 14 Unsure 2 0 1 4 3 10 Disagree 3 3 1 0 1 8 Strongly Disagree 4 4 0 0 1 9 Did not respond 0 0 1 0 1 2 Grand Total 16 11 3 6 12 48




June 2010

Q 15. To what extent do you agree with the following statement: Workers within my organisation know how to refer people to services available through Better Access.

Twenty seven per cent agreed with the statement that workers within their organisation know how to refer people to services available through Better Access. Forty per cent disagreed with this statement. Twenty three per cent were unsure and 10 per cent did not respond.

Workers within my organisation know how to refer people to services available through Better Access. Respondents Per cent Strongly Agree 1 2% Agree 12 25% Unsure 11 23% Disagree 11 23% Strongly Disagree 8 17% Did not respond 5 10% Grand Total 48 100%

Respondents Workers within my organisation know how to refer people to services available through Better Access. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 0 1 0 0 0 1 Agree 6 2 0 1 3 12 Unsure 1 2 1 3 4 11 Disagree 4 2 1 1 3 11 Strongly Disagree 3 4 0 0 1 8 Did not respond 2 0 1 1 1 5 Grand Total 16 11 3 6 12 48




June 2010

Q 16. To what extent do you agree with the following statement: Better Access has improved the mental health service system

Twenty seven per cent agreed with the statement that Better Access has improved the mental health service system. Nineteen per cent disagreed with this statement. Fifty four per cent were unsure.

Better Access has improved the mental health service system Respondents Per cent Strongly Agree 3 6% Agree 10 21% Unsure 26 54% Disagree 9 19% Grand Total 48 100%

Respondents Better Access has improved the mental health service system Metropolitan Regional Remote Rural Statewide Total Strongly Agree 2 0 0 0 1 3 Agree 3 3 0 0 4 10 Unsure 6 7 3 5 5 26 Disagree 5 1 0 1 2 9 Grand Total 16 11 3 6 12 48




June 2010

Q 17. To what extent do you agree with the following statement: Better Access provides referral options for people contacting my organisation who we would not normally provide services to.

Fourteen per cent agreed with the statement that Better Access provides referral options for people contacting their organisation who they would not normally provide services to. Thirty four per cent disagreed with this statement. Forty six per cent were unsure and six per cent did not respond.

Better Access provides referral options for people contacting my organisation who we would not normally provide services to. Respondents Per cent Strongly Agree 2 4% Agree 5 10% Unsure 22 46% Disagree 10 21% Strongly Disagree 6 13% Did not respond 3 6% Grand Total 48 100%

Respondents Better Access provides referral options for people contacting my organisation who we would not normally provide services to. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 1 0 0 0 1 2 Agree 1 1 0 0 3 5 Unsure 7 6 2 3 4 22 Disagree 5 2 0 2 1 10 Strongly Disagree 1 2 0 1 2 6 Did not respond 1 0 1 0 1 3 Grand Total 16 11 3 6 12 48




June 2010

Q 18. To what extent do you agree with the following statement: Better Access complements the services that my organisation provides

Forty one per cent agreed with the statement that Better Access complements the services that their organisation provides. Twenty three per cent disagreed with this statement. Twenty nine per cent were unsure and six per cent did not respond.

Better Access complements the services that my organisation provides Respondents Per cent Strongly Agree 4 8% Agree 16 33% Unsure 14 29% Disagree 9 19% Strongly Disagree 2 4% Did not respond 3 6% Grand Total 48 100%

Respondents Better Access complements the services that my organisation provides Metropolitan Regional Remote Rural Statewide Total Strongly Agree 2 0 0 0 2 4 Agree 4 5 0 2 5 16 Unsure 4 5 2 2 1 14 Disagree 6 1 0 1 1 9 Strongly Disagree 0 0 0 1 1 2 Did not respond 0 0 1 0 2 3 Grand Total 16 11 3 6 12 48




June 2010

Q 19. To what extent do you agree with the following statement: Better Access has reduced demand for the services that my organisation provides.

Only four per cent agreed with the statement that Better Access has reduced demand for the services that their organisation provides. Fifty two per cent disagreed with this statement. Thirty eight per cent were unsure and six per cent did not respond.

Better Access has reduced demand for the services that my organisation provides. Respondents Per cent Strongly Agree 1 2% Agree 1 2% Unsure 18 38% Disagree 17 35% Strongly Disagree 8 17% Did not respond 3 6% Grand Total 48 100%

Respondents Better Access has reduced demand for the services that my organisation provides. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 0 0 0 0 1 1 Agree 1 0 0 0 0 1 Unsure 4 6 2 2 4 18 Disagree 9 4 0 3 1 17 Strongly Disagree 2 1 0 1 4 8 Did not respond 0 0 1 0 2 3 Grand Total 16 11 3 6 12 48




June 2010

Q 20. To what extent do you agree with the following statement: Better Access has increased options for referral to mental health services for individuals using my service.

Twenty three per cent agreed with the statement that Better Access has increased options for referral to mental health services for individuals using their service. Thirty five per cent disagreed with this statement. Thirty three per cent were unsure and eight per cent did not respond.

Better Access has increased options for referral to mental health services for individuals using my service. Respondents Per cent Strongly Agree 3 6% Agree 8 17% Unsure 16 33% Disagree 12 25% Strongly Disagree 5 10% Did not respond 4 8% Grand Total 48 100%

Respondents Better Access has increased options for referral to mental health services for individuals using my service. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 2 0 0 0 1 3 Agree 2 2 0 1 3 8 Unsure 7 4 2 1 2 16 Disagree 4 3 0 3 2 12 Strongly Disagree 1 2 0 0 2 5 Did not respond 0 0 1 1 2 4 Grand Total 16 11 3 6 12 48




June 2010

Q 21. To what extent do you agree with the following statement: Better Access has had no real impact on the client group that my service works with.

Forty two per cent agreed with the statement that Better Access has had no real impact on the client group that their service works with. Twenty three per cent disagreed with this statement. Twenty five per cent were unsure and 10 per cent did not respond.

Better Access has had no real impact on the client group that my service works with. Respondents Per cent Strongly Agree 6 13% Agree 14 29% Unsure 12 25% Disagree 7 15% Strongly Disagree 4 8% Did not respond 5 10% Grand Total 48 100%

Respondents Better Access has had no real impact on the client group that my service works with. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 2 2 0 1 1 6 Agree 6 3 0 3 2 14 Unsure 4 3 2 1 2 12 Disagree 1 1 0 0 5 7 Strongly Disagree 2 2 0 0 0 4 Did not respond 1 0 1 1 2 5 Grand Total 16 11 3 6 12 48




June 2010

Q 22. To what extent do you agree with the following statement: My service receives many referrals from Better Access providers.

Only two per cent agreed with the statement that their service receives many referrals from Better Access providers. Sixty seven per cent disagreed with this statement. Twenty three per cent were unsure and eight per cent did not respond.

Workers within my organisation know how to refer people to services available through Better Access. Respondents Per cent Strongly Agree 1 2% Unsure 11 23% Disagree 12 25% Strongly Disagree 20 42% Did not respond 4 8% Grand Total 48 100%

Respondents Workers within my organisation know how to refer people to services available through Better Access. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 1 0 0 0 0 1 Unsure 4 2 1 1 3 11 Disagree 3 4 0 2 3 12 Strongly Disagree 8 5 1 2 4 20 Did not respond 0 0 1 1 2 4 Grand Total 16 11 3 6 12 48




June 2010

Q 23. To what extent do you agree with the following statement: My service encourages many patients to contact their GP to request a referral to allied health services through Better Access.

Thirty three per cent agreed with the statement that their service encourages many patients to contact their GP to request a referral to allied health services through Better Access. Thirty two per cent disagreed with this statement. Twenty five per cent were unsure and 10 per cent did not respond.

My service encourages many patients to contact their GP to request a referral to allied health services through Better Access. Respondents Per cent Strongly Agree 2 4% Agree 14 29% Unsure 12 25% Disagree 8 17% Strongly Disagree 7 15% Did not respond 5 10% Grand Total 48 100%

Respondents My service encourages many patients to contact their GP to request a referral to allied health services through Better Access. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 1 0 0 0 1 2 Agree 5 3 1 2 3 14 Unsure 3 1 1 2 5 12 Disagree 3 4 0 1 0 8 Strongly Disagree 3 3 0 0 1 7 Did not respond 1 0 1 1 2 5 Grand Total 16 11 3 6 12 48




June 2010

Q 24. To what extent do you agree with the following statement: Better Access providers work well with my service to provide coordinated care to clients using both services.

Only two per cent agreed with the statement that Better Access providers work well with their service to provide coordinated care to clients using both services. Fifty two per cent disagreed with this statement. Thirty eight per cent were unsure and eight per cent did not respond.

Better Access providers work well with my service to provide coordinated care to clients using both services. Respondents Per cent Agree 1 2% Unsure 18 38% Disagree 13 27% Strongly Disagree 12 25% Did not respond 4 8% Grand Total 48 100%

Respondents Better Access providers work well with my service to provide coordinated care to clients using both services. Metropolitan Regional Remote Rural Statewide Total Agree 1 0 0 0 0 1 Unsure 7 3 1 2 5 18 Disagree 5 3 0 3 2 13 Strongly Disagree 3 5 1 0 3 12 Did not respond 0 0 1 1 2 4 Grand Total 16 11 3 6 12 48




June 2010

Q 25. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain occupational therapists.

Two per cent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain occupational therapists. Forty six per cent disagreed with this statement. Forty four per cent were unsure and eight per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain occupational therapists. Respondents Per cent Strongly Agree 1 2% Unsure 21 44% Disagree 11 23% Strongly Disagree 11 23% Did not respond 4 8% Grand Total 48 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain occupational therapists. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 1 0 0 0 0 1 Unsure 5 5 2 4 5 21 Disagree 5 1 1 2 2 11 Strongly Disagree 5 3 0 0 3 11 Did not respond 0 2 0 0 2 4 Grand Total 16 11 3 6 12 48




June 2010

Q 26. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain psychiatrists.

No respondent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain psychiatrists. Forty eight per cent disagreed with this statement. Forty per cent were unsure and 13 per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain psychiatrists. Respondents Per cent Unsure 19 40% Disagree 12 25% Strongly Disagree 11 23% Did not respond 6 13% Grand Total 48 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain psychiatrists. Metropolitan Regional Remote Rural Statewide Total Unsure 7 3 1 4 4 19 Disagree 3 4 1 2 2 12 Strongly Disagree 5 2 0 0 4 11 Did not respond 1 2 1 0 2 6 Grand Total 16 11 3 6 12 48




June 2010

Q 27. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain psychologists.

Eight per cent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain psychologists. Forty four per cent disagreed with this statement. Thirty eight per cent were unsure and 10 per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain psychologists. Respondents Per cent Strongly Agree 3 6% Agree 1 2% Unsure 18 38% Disagree 11 23% Strongly Disagree 10 21% Did not respond 5 10% Grand Total 48 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain psychologists. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 2 1 0 0 0 3 Agree 0 0 0 1 0 1 Unsure 6 3 1 4 4 18 Disagree 4 3 1 1 2 11 Strongly Disagree 4 2 0 0 4 10 Did not respond 0 2 1 0 2 5 Grand Total 16 11 3 6 12 48




June 2010

Q 28. To what extent do you agree with the following statement: Better Access has reduced my organisation's ability to recruit and retain social workers.

Six per cent agreed with the statement that Better Access has reduced their organisation's ability to recruit and retain social workers. Forty four per cent disagreed with this statement. Thirty eight per cent were unsure and 13 per cent did not respond.

Better Access has reduced my organisation's ability to recruit and retain social workers. Respondents Per cent Strongly Agree 2 4% Agree 1 2% Unsure 18 38% Disagree 10 21% Strongly Disagree 11 23% Did not respond 6 13% Grand Total 48 100%

Respondents Better Access has reduced my organisation's ability to recruit and retain social workers. Metropolitan Regional Remote Rural Statewide Total Strongly Agree 1 1 0 0 0 2 Agree 0 1 0 0 0 1 Unsure 5 4 1 4 4 18 Disagree 3 2 1 2 2 10 Strongly Disagree 6 1 0 0 4 11 Did not respond 1 2 1 0 2 6 Grand Total 16 11 3 6 12 48





June 2010

148

Q 29. To what extent do you agree with the following statement: Better Access has increased training and professional development opportunities for my staff.

No respondent agreed with the statement that Better Access has increased training and professional development opportunities for their staff. Fifty two per cent disagreed with this statement. Thirty five per cent were unsure and 13 per cent did not respond.

Better Access has increased training and professional development opportunities for my staff. Respondents Per cent Unsure 17 35% Disagree 13 27% Strongly Disagree 12 25% Did not respond 6 13% Grand Total 48 100%

Respondents BAI has contributed to improved mental health outcomes for people living in remote communities. Metropolitan Regional Remote Rural Statewide Total Unsure 5 2 1 4 5 17 Disagree 5 4 1 2 1 13 Strongly Disagree 6 2 0 0 4 12 Did not respond 0 3 1 0 2 6 Grand Total 16 11 3 6 12 48



June 2010

6.2 Comments from survey of NGO providers

6.2.1 Profile of NGO respondents providing comment Of the 48 respondents to the survey, 18 (38 per cent) provided additional comments regarding the Better Access initiative. Of these respondents, 11 (61 per cent) were from New South Wales, five (28 per cent) were from Western Australia and one each were from South Australia and Victoria. Forty four per cent of respondents provided a statewide service, 28 per cent provided service in a metropolitan area and 28 per cent provided service in a regional or rural area.

6.2.2 Comments received on survey Note: Comments that were not relevant to the project/survey have not been included.

Statewide, Direct mental health service provider, WA We have to my knowledge, not had any contact with the initiative, hence strongly disagree on some questions. (#11)

Regional area, Direct mental health service provider, NSW We are not aware of this initiative. (#16)

Statewide Direct mental health service provider NSW We are an NGO so the last set of questions are rated as unsure as they do not have relevance for us. We deal with people with major and disabling mental illness. I am not aware of any service user of our organisation getting access to the Better Access. (#21)

Regional area Support and information to carers NSW We are a bit unsure what the Better Access initiative is? Maybe we are a bit naive sorry. (#30)

Regional area Consumer advocacy and support service NSW Until this survey, I haven't known about Better Access. I would like to think that Better Access can assist us in the future in the Coffs/Clarence. (#37)

Metropolitan area Direct mental health service provider WA This is probably a useful initiative for people with mild to moderate mental illnesses, and the worried well. It will undoubtedly improve financial position of OTs, psychologists, social workers and psychiatrists. 12 sessions is not enough for people with more severe conditions. (#7)

Statewide Peak WA There is still very limited access to allied health providers in rural and remote areas. (#10)

Statewide Consumer advocacy and support service NSW The Better Access scheme has improved access to services for consumers who need short based therapy. It has not been able to be of assistance to those with ongoing mental health problems. (#15)




June 2010

Rural area Direct mental health service provider WA The Better Access initiative has not demonstrated any real change from an NGO perspective, however it has reached some clients from other sources. Networking and inclusion of NGO services has been limited from this agency's perspective. (#12)

Rural area Support and information to carers NSW No (#39)

Metropolitan area Direct mental health service provider NSW Many services are fragmented and it can be difficult even for service providers to find out information. It is even more difficult for carers and consumers to be aware of all the available services and often GPs do not know what services are available. (#45)

Metropolitan area Direct mental health service provider NSW I really don't have any idea of what Better Access initiative is, how to access it or what its involvement is with my organisation. We may receive input or support may be given to our consumers from Better Access, however i am completely unaware of anything. . . .(incomplete comment) (#46)

Regional area Direct mental health service provider VIC I manage a small peri natal and infant mental health service. We provide counselling for (usually) women with anxiety and depression but also triage and refer for medical assessment and management when required. GPs do seem to refer clients to both my service and Better Access. (#42)

Metropolitan area Consumer advocacy and support service NSW I am not familiar with the term 'Better Access Initiative', however have heard about 'GP shared care' and wonder if it is the same thing. (#27)

Metropolitan area Direct mental health service provider WA Better access appears not to have any requirement to ensure that plans developed look at the needs of the whole person and consider the role of other agency supports that could assist with recovery. (#6)

Statewide Direct mental health service provider NSW BA is an irrelevant service so far as our organisation is concerned. We provide a direct, unique, highly successful service for survivors of childhood trauma. Survivors tell us that, until Mayumarri, they received no help in overcoming their problems. (#17)

Statewide Direct mental health service provider NSW Although I am part of a larger organisation, I have answered the questions predominantly in relation to the respite service. The Better Access initiative is a great concept. (#33)

Statewide Consumer advocacy and support service SA A prominent concern still exists for the training of GPs in utilising the Better Access Initiative. I hear many reports of clients accessing GPs to be turned away without adequate assistance for Major Depression and Suicidal Ideation. (#43)




June 2010

7 Survey of consumers

7.1 Sampling Information on the evaluation and hyperlink to the survey was placed on the website of Beyond Blue and the Public Mental Health Consumers network. Information was also provided to other peak consumers and carer NGO organisations via the peak mental health NGO in each state or territory.

The survey was live for a five week period . There were 125 responses to the survey.

7.2 Responses to survey of consumers

Q1. What is your age?

Forty two per cent of consumers were aged from 25 to 44 years, 42 per cent were aged from 45 to 64 and 10 per cent were aged from 16 to 24 years.

Age of respondents Respondents

Less than 16 years 1

16 to 24 years 13

25 to 44 years 53

45 to 64 years 52

65 years and older 3

Did not respond 3

Total 125

Q2. What is your gender?

Seventy per cent of respondents were female.

Gender of respondents Respondents

Male 35

Female 88

Did not respond 2

Total 125




June 2010

Q3. Postcode of residence? Approximately 30 per cent of respondents were from New South Wales, 28 per cent were from Victoria, 17 per cent were from Queensland, 13 per cent were from South Australia and six per cent were from Western Australia. The Territories and Tasmania combined made up the remaining six per cent of respondents.

Gender of respondents Respondents

New South Wales 37 Victoria 35 Queensland 21 South Australia 16 Western Australia 7 Australian Capital Territory 3 Tasmania 3 Northern Territory 1 Did not respond 2 Total 125

Q4. In the last 12 months have you consulted a GP, private psychiatrist, private paediatrician or private allied health provider (psychologist, occupational therapist, social worker) about a mental health problem you were experiencing? Nearly all (94 per cent) of respondents had consulted a GP, private psychiatrist, private paediatrician or private allied health provider (psychologist, occupational therapist, social worker in the last year.

Consulted a GP, psychiatrist, paediatrician or allied health provider

Respondents Per cent

Yes 118 94% No 4 3% Did not respond 3 2% Total 125




June 2010

Q4a. Did you consult a GP for this mental health problem?

Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, nearly half (49 per cent) reported that they had consulted a GP for their mental health problem. Fourteen per cent reported that they did not consult a GP and 37 per cent did not respond.

Consulted a GP, psychiatrist, paediatrician or allied health provider


Yes 58 49% No 16 14% Did not respond 44 37% Total having consulted a provider in last 12 months 118 100%

4ai. Did your GP prepare a mental health care plan? Of the 58 respondents who had consulted a GP, almost 60 per cent reported that their GP had prepared a mental health care plan and 38 per cent reported that the GP did not prepare a care plan.

GP prepared a Mental Health Care Plan Respondents Per cent

Yes 34 59% No 22 38% Don't know 2 3% Total 58 100%

Q4aii. What care did you receive from your GP in relation to your mental health problem?

Sixty six per cent of respondents having seen a GP in the last 12 months reported receiving medication and approximately one-third received a referral to an AHP or psychiatrist.

Care received from GP Respondents Per cent

Medication 38 66% Referral to a psychologist, social worker or occupational therapist 20 34% Referral to a psychiatrist 17 29% Psychological therapy 7 12% Other 9 16% Total 58 *

* Respondents may receive multiple types of care




June 2010

Q4b. Did you consult a psychiatrist about this mental health problem? Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, 42 per cent reported that they had seen a psychiatrist, and 23 per cent reported that they did not consult a psychiatrist.

Consulted a psychiatrist Respondents Per cent

Yes 49 42% No 27 23% Did not respond 42 36% Total 118 100%

Q4bi. What care did you receive from your psychiatrist in relation to your mental health problem? The proportion of respondents receiving medication from psychiatrists was similar to the number that reported receiving medication from their GP. A greater number of respondents reported receiving psychological therapy from a psychiatrist than did respondents reporting care from their GP .

Care received from GP Respondents Per cent

Medication 40 82% Referral to a psychologist, social worker or occupational therapist 9 18% Referral to a different psychiatrist 0 0% Psychological therapy 30 61% Other 10 20% Total 49 *

* Respondents may receive multiple types of care




June 2010

Q4c. Did you consult an allied health provider (psychologist, social worker or occupational therapist) about this mental health problem?

Forty one per cent of respondents reported having consulted with an allied health provider in the last 12 months, and 30 per cent indicated that they did not consult with an allied health provider. Thirty per cent of respondents did not respond to this question.

Consulted with a private allied health provider Respondents Per cent

Yes* 48 38% No 36 29% Did not respond 41 33% Grand Total 125 100%

* Includes one respondent who did not report having consulted with a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months

Q4ci. How many times did you see the allied health provider (psychologist, social worker or occupational therapist)? Of the respondents having consulted with a private allied health provider, 69 per cent reported seeing the allied health provider seven or more times.

Number of sessions with a private allied health provider Respondents Per cent

One to six sessions 14 29% More than 12 sessions 18 38% Seven to twelve sessions 15 31% (blank) 1 2% Grand Total 48 100%

Q4cii. Did you receive a Medicare rebate for any of these services from the allied health provider (psychologist, social worker or occupational therapist)? Sixty five per cent of respondents seeing a private allied health provider reported receiving a Medicare rebate. Almost one-third did not receive a Medicare rebate.

Received a Medicare rebate for seeing a private allied health provider






June 2010

Q4ciii. Are you still seeing your allied health provider (psychologist, social worker or occupational therapist)? Fifty eight per cent of those respondents reporting having seen a private allied health provider are still seeing their allied health provider, 40 per cent are not.

Still seeing a private allied health provider Respondents Per cent


Q4civ. How often are you seeing your allied health provider (psychologist, social worker or occupational therapist)? Of the 28 respondents currently seeing a private allied health provider, 63 per cent reported seeing the allied health provider monthly or occasionally, when needed.

Frequency of seeing an private allied health provider Respondents Per cent

Weekly 5 18% Fortnightly 6 21% Monthly 15 54% Occasionally, when needed 2 7% Total 28 100%

Q4cv. Do you feel that you had enough sessions with your allied health provider (psychologist, social worker or occupational therapist)? Of the 19 respondents who were no longer seeing a private allied health provider, half did not feel that they had had enough sessions.

Enough sessions with private allied health provider Respondents Per cent

Yes, about right 8 42% No, not as many as needed 10 53% Did not respond 1 5% Total 19 100%




June 2010

Q5. Overall, did the services you received for your mental health problem help you?

Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, 81 per cent reported that they felt better after receiving services, 14 per cent reported that the services made no real difference and five per cent reported that they felt worse.

Helpfulness of services Respondents Per cent

Yes, I feel much better 47 40% Yes, I feel somewhat better 48 41% The services made no real difference 17 14% No, I feel somewhat worse 2 2% No, I feel much worse 3 3% Did not respond 1 1% Total 118 100%

Q6. Overall, to what extent do you agree that the services were affordable?

Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, 54 per cent agreed that services and 35 per cent did not.

Affordability of services Respondents Per cent

Strongly Agree 18 15% Agree 46 39% Unsure 10 8% Disagree 25 21% Strongly Disagree 17 14% Did not respond 2 2% Grand Total 118 100%




June 2010

Q7. Overall, to what extent do you agree that waiting times for the services were acceptable? Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, 60 per cent of respondents thought waiting times were acceptable, 29 per cent did not.

Acceptability of waiting times Respondents Per cent


Q8. Overall, to what extent do you agree that allied health providers (psychologists, social workers and occupational therapists) were available in your local area? Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, 47 per cent of respondents thought that allied health providers were available in their local area, and 51 per cent were unsure or did not think services were available.

Availability in local area Respondents Per cent





June 2010

Q9. Overall, did the services meet your needs? Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, 67 per cent of respondents were satisfied that services met their needs and 19 per cent were unsure or dissatisfied.

Satisfaction that needs were met Respondents Per cent

Yes, I am very satisfied with the services 35 30% Yes, I am satisfied with the services 44 37% I am neither satisfied or dissatisfied 15 13% No, I am dissatisfied with the services 10 8% No, I am very dissatisfied with the services 10 8% Did not respond 4 3% Total 118 100%

Q10. If a family member or friend were experiencing a mental health problem, would you recommend to them that they seek a referral to a therapist from their GP through Medicare?

Of the 118 respondents who reported that they consulted a GP, private psychiatrist, private paediatrician or private allied health provider in the last 12 months, 83 per cent indicated a likelihood of recommending a friend/family member to seek referral to therapist via their GP and Medicare, only three per cent indicated that it was unlikely that they would so recommend.

Satisfaction that needs were met Respondents Per cent

Yes, certainly 78 66% Possibly 20 17% Not sure 10 8% Unlikely 4 3% Did not respond 6 5% Total 118 100%

7.3 Comments from survey of consumers

Female aged 16 to 24 years, Major City, VIC For severe and long term mental health difficulties, more than 12 sessions are sometimes required. I currently access a private psychiatrist twice weekly and have for the last four years. However, for those who cannot afford private health cover and need more…. (#66)




June 2010

Female aged 16 to 24 years, Major City, VIC Mental health disorders are already social taboos, having lack of access to available services makes life just that little bit harder. (#18)

Female aged 16 to 24 years Outer Regional NSW I had the experience of having to wait eight weeks with my GP's referral to a psychologist from the Division of GP. I then learnt that I could actually find my own. I didn't have to wait to be seen, and whilst I had to pay an extra $45 to see them,… (#81)

Female aged 16 to 24 years Rebate for REGISTERED psychologists needs to be the same as clinical psychologists. There is no prejudice between the 2 types of professionals for sufferers of mental disorders, that they are both entirely and equally accessible. (#110)

Female aged 25 to 44 years Major City ACT The completion of the Mental Health Plan by the GP was unhelpful for the GP and myself. It was a formality they had to complete to enable me to access the Better Access initiative and made no difference to the treatment they provided. All it did was cost me. . . .(incomplete comment) (#107)

Female aged 25 to 44 years Major City ACT There needs to be more information about it 'out there'. Are the people who have accessed it those who were already accessing services but now get to do it subsidised? I suspect so. I've heard from others that some GPs tell clients it is a waste of money. (#5)

Female aged 25 to 44 years Major City ACT Yes, it should be for an unlimited amount of sessions, not limited to I think 12 in one year. (#98)

Female aged 25 to 44 years Major City NSW Have recommended this many times. I found it to be very helpful. Awareness and easier access to mental health professionals is critical to managing these illnesses. I believe we are understaffed in rural areas and I hope this can be addressed. (#21)

Female aged 25 to 44 years Major City NSW I have to travel 2.5 hours by public transport each way (so 5 hours in total) to see a decent psychiatrist. I have tried the public system psychiatrists but every time I went they kept asking me if I was suicidal or wanted to harm myself. (#113)

Female aged 25 to 44 years Major City NSW I have to travel from Beaumont Hills to Burwood (St John of God Medical Centre) to see my psychiatrist on a monthly basis. I believe that GPs require more information on depression and anxiety as I have been suffering for 13 years before my GP decided to refer me. (#42)

Female aged 25 to 44 years Major City NSW It is one thing to have access to a health practitioner (eg GP) but quite another to have them facilitate access to further practitioners. My GP refused me a mental health plan as, in his words, "a psychologist can't make my problems go away." (#29)

Female aged 25 to 44 years Major City NSW Psychological and Psychiatric services are great-need them in a quicker timeframe or your Mental Health decreases. (#82)




June 2010

Female aged 25 to 44 years Major City NSW Services need to treat the whole person, need to be free or cheap and waiting times must be as short as possible. System requires more government spending! Schools also require more counsellors! (#115)

Female aged 25 to 44 years Major City NSW The care I received was on the whole excellent. My only issue was that I had a terrible experience at an acute psychiatric ward as there were no beds available in a more suitable specialised mother baby unit and as such suffered longer. (#36)

Female aged 25 to 44 years Major City QLD I ran out of the 12 ones per year at a time when I needed them. (You only get 12 sessions a year apparently.) I found that I got a lot better when I started going to the sea/sun with a friend once a week and swimming in the sea, relaxing and having a chat. (#83)

Female aged 25 to 44 years Major City QLD To overcome Depression, you really need to see a Therapist for quite a long time. They tend to be expensive and I had to give up before I was in any way better, merely because I could not afford it. I now feel I am on my own as I can't afford to see a Therapist. (#77)

Female aged 25 to 44 years Major City VIC GPs need to be better educated about mental illness so that they make referrals not just a prescription. (#76)

Female aged 25 to 44 years Major City VIC I feel that as a sufferer of depression, single, working/studying part time and in my late 20's I don't get enough support from the government or medical profession to help me beat this illness. I struggle with my medication bills, add to that the limited . . . .(incomplete comment) (#85)

Female aged 25 to 44 years Major City VIC I think it is a fantastic step in the right direction but it shouldn't end here. Greater education is needed all the time advising people where to go and what to do and what resources are available to them before they become desperate. (#35)

Female aged 25 to 44 years Major City VIC I think it's wonderful that this is being given such consideration. I am unfamiliar with the public system in this respect, having been referred to my psychiatrist by my endocrinologist, but I am aware that there are issues with waiting times & the system. . . .(incomplete comment) (#119)

Female aged 25 to 44 years Major City VIC In reference to question 6, the costs of treatment were only affordable with the Medicare rebate. Without the rebate, I would have been unable to seek the ongoing treatment I required. (#44)

Female aged 25 to 44 years Major City VIC It was great to see an allied professional (clinical psychologist) who specialised in my problem areas (borderline personality disorder) and who could target the treatment specifically to me in conjunction with my psychiatrist prescribing medication. (#65)




June 2010

Female aged 25 to 44 years Major City WA I think the cost of the allied health professionals is still too expensive, and there should be more of a Medicare rebate made available, especially for those on benefits or low incomes. (#33)

Female aged 25 to 44 years Outer Regional QLD Psychology appointments undertaken were at no cost, this may have been funded through Medicare, not really sure. Medications however are quite expensive. (#38)

Female aged 25 to 44 years Outer Regional QLD Service from Health Professionals is good, but access to them especially in emergencies is bad. Appointments can take weeks, and if you are mentally ill this can seem like a life time. (#112)

Female aged 25 to 44 years Outer Regional VIC The treatments from the psychologist were not evidence based, just talking, no plan, no evaluation of where we were, no direction in the treatments, very crisis driven and not helpful. Made no attempt to refer me to a psychiatrist even though my symptoms . . . .(#6)

Female aged 25 to 44 years Outer Regional WA My GP firstly didn't do a mental health care plan as she didn't have time so I was referred to a psychiatrist who I had to pay without any rebate because of my doctor. Finding the right psychiatrist is important for the individual’s recovery. (#26)

Female aged 45 to 64 years Inner Regional NSW There were not enough sessions. (#60)

Female aged 45 to 64 years Inner Regional SA I think for the purpose of this survey, you are only asking the experience of obtaining the allied health aspect of the service. What about the experience of the GP doing the health care plan. My experience of this was appalling (#8)

Female aged 45 to 64 years Inner Regional TAS I am not satisfied with the availability of Medicare rebate in respect of clinical psychologist, etc without reference to their training and practice while it is not available in respect of services provided by others including counsellors with very high skills. (#22)

Female aged 45 to 64 years Inner Regional VIC More public awareness of this scheme would be positive. (#116)

Female aged 45 to 64 years Major City NSW As someone who has a heart arrhythmia that is often mistaken as an anxiety condition, I feel I can comment on services for people with at least anxiety disorders. I understand that there is a Better Access initiative allowing access to psychologists etc (#125)

Female aged 45 to 64 years Major City NSW I believe that there should be Medicare only access to quality psychiatrists. (#45)

Female aged 45 to 64 years Major City NSW I was seeing a psychologist for months before the initiative rebates began and getting very little rebate from my health fund and looking at having to stop. Now I feel that I am able to get the help I need without so much worry of cost (#57)




June 2010

Female aged 45 to 64 years Major City NSW In the past 10 years, I have needed to access Mental Health Services for my daughter and have been somewhat disappointed in the result being referred to one department to another, when someone is in distress and has threatened suicide these services should be easy. . . .(incomplete comment) (#121)

Female aged 45 to 64 years Major City NSW It is less stigmatising than having a case manager in the public system. Also having GP means more likely to get care for both mental and physical health together, and it avoids the medication- more medication- side effects- multi medication – diabetes. (#89)

Female aged 45 to 64 years Major City NSW Thank you for this opportunity to comment. Access would be improved if there were rebates available, through Medicare and private health insurance schemes, for visits to counsellors/therapists as well. (#37)

Female aged 45 to 64 years Major City NSW This initiative helped me as I was very distressed after the break-up of a relationship. I was supported at every step by the GP, who was concerned that I might become suicidal. I was referred to the Extended Hours Team (community mental health service). (#9)

Female aged 45 to 64 years Major City QLD Fours years ago, I was diagnosed with Bipolar Disorder. Took me two years to recover. Use all health services available. Now see psychiatrist for a check up each year. Have Blood tests for Lithium levels. Have my own individual Stay Well Plan to keep healthy. (#20)

Female aged 45 to 64 years Major City QLD I feel that the costs of mental heath providers, mainly psychologists, are totally out of reach for the average family. Although the 12 week Medicare rebate does help anyone with mental health problems, in general need more then 12 weeks of seeing a mental health specialist. (#106)

Female aged 45 to 64 years Major City QLD I think it should be a lot easier to see a doctor through the Hospital system. (#12)

Female aged 45 to 64 years Major City QLD It has assisted me in accessing services that I would not normally be able to afford. (#91)

Female aged 45 to 64 years Major City QLD The Better Access Initiative has made allied health services available and accessible to everyone, not just those who have private health insurance or financial capability to pay for services. This initiative should be continued and more people informed of availability. (#108)

Female aged 45 to 64 years Major City SA Make it more highly promoted - not just web sites but everywhere but in particular to medical professions as well. (#84)




June 2010

Female aged 45 to 64 years Major City SA Many organisations funded by government who claim to offer a 'service' only keep lists of other people who offer 'service'. None of them actually do any work. More variety is needed than just talking eg art, narrative etc. (#92)

Female aged 45 to 64 years Major City VIC I am in a position to afford to pay $100 for my weekly session with my psychotherapist and sometimes I feel a bit guilty about getting a Medicare rebate when there are probably people who need it more than I do. On the other hand, I have a severe and enduring problem. (#4)

Female aged 45 to 64 years Major City VIC I believe that Family Therapists (qualified) should also be included in the Medicare rebate. I was seeing a psychologist for $150 per session, now see a family therapist at same clinic, who is meeting my needs fantastically and better than the original psychologist. (#34)

Female aged 45 to 64 years Major City VIC Up front fees can be very expensive for those on limited income, may deter some people from seeking help. There is a need for "follow up" support groups in outer "metro" areas. (#79)

Female aged 45 to 64 years Major City WA I was referred to local mental heath service which was helpful; however part of the reason for my depression is due to severe back pain and GP REFUSED to carry out Better Access for physio even after I stated as a resident of Australia was entitled to it. (#101)

Female aged 45 to 64 years Major City WA NOT sure as I only go to mental health clinic but I have a great GP who works in partnership with my psychiatrist. (#7)

Female aged 45 to 64 years Outer Regional SA It is good that some funding is now available to help with the costs of seeing a psychologist etc. BUT

a) six weeks is usually nowhere near long enough to sort out most problems

b) you have to be able to access these services which is often extremely hard. (#88)

Female aged 45 to 64 years Outer Regional TAS I have suffered with depression for years. Sometimes I cope other times I don't. I have other health issues and problems, i.e. two heart attacks at 45, diabetic, asthmatic, migraine sufferer, just to name a few. (#43)

Female aged 65 years and over Major City SA I have been very fortunate with the help I have received from both my GP and psychologist. I feel it is very important for a patient to have good rapport with both the GP and psychologist for positive results. (#105)

Female aged Less than 16 Outer Regional NSW My local services were very few, but when I had to go to an adolescent Mental Health unit it made me worse. I needed to be with my mum and Dad and I wasn't allowed and so I got worse. (#78)




June 2010

Male aged 16 to 24 years Major City VIC I chose a non clinical psychologist because I wanted to talk about my life goals and how to mange my mental health condition. (#10)

Male aged 25 to 44 years Inner Regional QLD I have found that the Better Access Plan is a great help with the cost of seeing a Psychologist. I would like to see more sessions per year, as I found 12 per year is not enough for when a person needs a lot of help. (#87)

Male aged 25 to 44 years Inner Regional VIC I am hoping this will help fill in the gaps within the primary care in allied health. (#74)

Male aged 25 to 44 years Inner Regional WA I think any advancement in treating mental health problems early, affordably and with understanding will advance our society and make a real difference to individuals who have suffered silently and shamefully because of the misinformation and negligence. (#46)

Male aged 25 to 44 years Major City VIC I think any initiative that may contribute to more accessible and affordable treatment for sufferers is a good thing. A fortune gets spent by the Govt/TAC (rightly so) to address the road toll which is something everyone identifies with. Why should mental health be different. (#15)

Male aged 25 to 44 years Major City VIC There are many issues with the public mental health system, far beyond the reach of this survey. (#69)

Male aged 25 to 44 years Major City VIC There should be more information for local areas. (#75)

Male aged 45 to 64 years Inner Regional NSW I believe we need a resource centre in our town like or similar to the one at 132 Prince Street, Grafton 2460. For starters, it would be a great place for consumers and carers to meet and socialize, share information stories etc. Numerous possibilities. (#95)

Male aged 45 to 64 years Inner Regional NSW Will the Initiative be looking at ways to increase the number of psychiatrists in rural/remote areas? (#28)

Male aged 45 to 64 years Inner Regional SA There has been no residential or visiting psychiatrist to my town since 2007 and I only have a social worker and GP which can see me regularly providing there is an appointment available. Demands on their time are high. (#73)

Male aged 45 to 64 years Major City NSW Getting the GP to complete a form is hard enough. Finding a psychologist to see is even harder! (#97)

Male aged 45 to 64 years Major City NSW There is still considerable stigma attached to Mental health and its treatment. The fact that it is difficult to access help only feeds that stigma. GPs tend to medicate problems without offering real alternatives or complimentary remedies or strategies. (#71)




June 2010

Male aged 45 to 64 years Major City QLD I am in a more fortunate (or unfortunate) position than most people suffering similar problems to myself, because I am a Vietnam veteran, and my conditions resulted from that part of my life. Therefore, I am able to access services which are accessible easily through DVA. (#100)

Male aged 45 to 64 years Major City SA I consult a psychiatrist for an organic mental disorder. I would not consult an allied therapist. (#62)

Male aged 45 to 64 years Major City SA I have multiple chemical sensitivity, a condition whose aetiology is unknown but which is often associated with neuro-psychological complaints. Whatever the cause may be, the symptoms of MCS following chemical exposures are severe and often extreling(?). (#86)

Male aged 45 to 64 years Major City SA Mental health is proceduralized to the detriment of the consumer. I have been abused and witnessed dear ones suffer abuse as a direct result of vulnerable situations they were put in by mental health treatments. Dangerous cowbows. (#123)

Male aged 45 to 64 years Major City SA The more 'open' the issue of mental illness is made will help take away the embarrassment that consumers feel of admitting to it. Mental illness MUST be considered to be an illness, if diagnosed by a credited doctor, and should be recognised as such. (#99)

Male aged 45 to 64 years Major City VIC I think the stigma attached to mental health problems is a major problem. Poster advertising campaigns in Melbourne in recent months have been excellent. (#39)

Male aged 45 to 64 years Major City VIC My psychiatrist bulk bills and, as an ongoing patient for over 10 years, I have ready access. Hence my comments may not relate to the BAI. (#104)

Male aged 45 to 64 years Major City VIC Psychiatrists are crucial and almost impossible to see! (#52)

Male aged 45 to 64 years Major City VIC There are many choices regarding access to help and these are to be made by the patient. Oftentimes the patient is not able to make the right choice, because of a lack of information or because of the nature of the illness. (#64)

Male aged 45 to 64 years Major City VIC There seems to have been an explosion in the need for access to mental health professionals but not enough of them to go round! (#80)

Male aged 65 years and over Major City VIC I question the usefulness of a simplistic survey such as this. People being happy with the service etc does not mean that they will have received the right treatment. Whether one would advise someone to see an allied health professional would depend upon their condition. (#103)




June 2010

8 Survey of carers

8.1 Sampling Information on the evaluation and hyperlink to the survey was placed on the website of Beyond Blue and the Public Mental Health Consumers network. Information was also provided to other peak consumers and carer NGO organisations via the peak mental health NGO in each state or territory.

The survey was live for a five week period. There were 30 responses to the survey.

8.2 Responses to survey of carers Due to low sample size, percentages are not reported.

Q1. What is your age and gender?

Over half of respondents were older than 45 years. There were few respondents over the age of 65 years. Most respondents were female.

Age Female Male Gender not given Total Children 0 - 12 1 1 25 to 44 years 7 1 8 45 to 64 years 13 4 17 65 years and over 2 1 3 Did not respond 1 1 Grand Total 22 7 1 30

Q2 and Q3. State and region of residence Almost half of respondents were from NSW and most were from major cities and inner regional areas.

Region Inner

Regional Major City Outer

Regional Did not respond Total

NSW 3 12 1 16 SA 1 4 5 VIC 1 2 3 NT 1 1 QLD 1 1 (blank) 4 4 Grand Total 5 19 2 4 30




June 2010

Q4. Who do you care for that is a user of mental health services? Most respondents reported that they provided care to their child.

Care provided to Respondents

Child 13 Partner 8 Parent 5 Brother, sister or other close family member 4 Total 30

Q5. Has the person you care for seen a GP for assistance with a mental health problem?

Most respondents reported that the person they cared for had been to see a GP and that the waiting times to see the GP were acceptable.

Person cared for has seen a GP Respondents

Yes 24 No 6 Total 30

Q5a. To what extent do you agree with the following statement: I thought the waiting time to see the GP was acceptable.

Waiting time to see GP was acceptable Respondents

Strongly agree 7 Agree 12 Disagree 4 Strongly disagree 1 Total 24

Q6. Did the GP refer the person you care for to an allied health provider (psychologist, social worker or occupational therapist)?

Of the 24 carers reporting that the person they cared for had been to see a GP, most reported that the GP referred the person they care for to an allied health provider.

Referral to an allied health provider Respondents

Yes 19 No 5 Total 24




June 2010

Q7a. I thought the waiting time to see the allied health provider (psychologist, social worker, occupational therapist) was unacceptable? Of the 19 carers reporting that the person they cared for had been referred to an allied health provider, more than half reported the waiting time as unacceptable.

Waiting time to see the allied health provider was acceptable

Respondents

Strongly Agree 1 Agree 2 Unsure 1 Disagree 4 Strongly Disagree 4 Did not respond 7 Total 19

Q7b. I thought the out of pocket payments were affordable. Of the 19 carers reporting that the person they cared for had been referred to an allied health provider, approximately half of respondents considered out of pocket expenses were affordable.

Out of pocket expenses were affordable Respondents

Strongly Agree 1 Agree 5 Disagree 5 Strongly Disagree 1 Unsure 1 Did not respond 6 Total 19




June 2010

Q7c. The services provided to the person I care for helped them Of the 19 carers reporting that the person they cared for had been referred to an allied health provider, more than half reported that the services were helpful.

Services were helpful Respondents

Strongly Agree 4 Agree 4 Unsure 1 Disagree 2 Strongly Disagree 1 Did not respond 7 Total 19

Q7d. The services provided to the person I care for made things easier for me

Services were made things easier Respondents

Strongly Agree 1 Agree 5 Unsure 1 Disagree 1 Did not respond 11 Total 19

Q7e. The mental health services for the person you care for were available in your local area

Services were made things easier Respondents

Strongly Agree 1 Agree 3 Disagree 2 Strongly Disagree 3 Did not respond 10 Total 19

8.3 Comments from survey of carers

Female aged 25 to 44 years, Major City, NSW Caring for sibling or close family member. There needs to be an obvious and well known source of appropriate information eg. a website, Centrelink or Family assistance office, for all services required by Mental Health Users and carers in their local area-a one stop shop of services available in the community. (#19)




June 2010

Female aged 25 to 44 years, Major City, NSW, Caring for sibling or close family member Psychiatrists need to refer patients to it more often for it to have any use or effect on a consumers’ well being. (#11)

Female aged 45 to 64 years, Inner Regional, NSW, Caring for child My daughter has been using the Better Access Initiative since it started. Initially she was given the referral by her GP with no consultation with me as her carer. The main problem being that for her to access the service she needed $110 cash up front. (#27)

Female aged 45 to 64 years, Inner Regional, NSW, Caring for partner I have been in the caring role since before the Better Access Initiative. If this was in place during our time, it would have given us more choice at a lot less expense. I am not sure how useful it would have been as the person i care for needed frequent treatment. (#9)

Female aged 45 to 64 years, Major City, NSW, Caring for child With waiting lists so long in regional areas like ours, couldn't some sort of "priority" system be in place to fast track those requiring urgent attention? I'm talking about those with serious self-harm or aggression issues. (#31)

Female aged 45 to 64 years, Major City, NSW, Caring for partner I think that GPs need more knowledge in regard to communicating with people who have mental health issues. I understand that Doctors have an overwhelming workload however, taking the time to talk to the patient and their carer and make sure that there is. . . .(incomplete comment) (#15)

Female aged 45 to 64 years, Major City, NSW, Caring for partner Access should be provided where the carer and consumer have a joint visit occasionally. (#6)

Female aged 45 to 64 years, Major City, NSW, Caring for child Twelve services may not be enough for someone with a longstanding psychological/mental health issue. (#10)

Female aged 45 to 64 years, Major City, QLD, Caring for child I was told that we were not eligible because he was not taking any medication. I had to pay for all the services full price. There is no extras refund from MBF for psychology and nothing from Medicare. Even with his own Health Care Card, I had to pay full price. (#32)

Female aged 45 to 64 years, Major City, SA, Caring for partner Many attempts are made to get a diagnosis, without success, so no treatment was available, but information was used to prove incapacity. (#24)

Female aged 45 to 64 years, Major City, VIC, Caring for child Yes, I think that the divide between clinical and generalist psychologists is destructive, non evidence based and damaging in the narrowing of effective therapeutic interventions. (#4)

Female aged 45 to 64 years, Major City, VIC, Caring for partner There were providers in our area but too difficult to access in an acceptable timeframe. (#7)




June 2010

Female aged 45 to 64 years, Caring for child The person I care for doesn't live within the same postcode as myself. (#23)

Female aged 65 years and over, Inner Regional, VIC, Caring for child The efficiency of the service seems to depend on the relationship the family already has with the GP. The GP's knowledge of the family, its general health and background facilitates Better Access. (#29)

Female aged 65 years and over, Major City, NSW, Caring for child The time the doctors spend with the patient is minimal and the intervals between appointments is far too long (three months). The other problem is that the patient doesn’t see the same doctor.. (#13)

Female aged 45 to 64 years, Major City, SA Caring for partner The B.A. initiative is good, but needs much extending, especially rurally. (#30)

Male aged 25 to 44 years, Inner Regional, NSW, Caring for a parent The better outcomes initiative is corrupted by GP services only referring to their own psychologists in the practice. I waited months for my mother to be seen by a Psychologist from the Division of GP in the surgery, only to discover that we could in fact see one through Better Access. (#18)

Male aged 45 to 64 years, Major City, NSW, Caring for child These resources are stretched to the limit, which means that sometimes the person I care for can only get basic help. There is a need for more thorough follow-up at my local level. (#20)

Male aged 45 to 64 years, Major City, NSW, Caring for a parent GPs seem reluctant to complete the paperwork that is required in this process. (#28)

Male aged 45 to 64 years, Major City, SA, Caring for partner Anything that can make any part of the caring procedure less complicated and quicker can only be OF GREAT VALUE. (#21)

Male aged 65 years and over, Major City, SA, Caring for child I write as a desperate Caring for a parent. Our adopted son is 35, has bi-polar and sees a private psychiatrist. We pay all medical bills and health insurance, and significant other bills to keep him in public housing so he has a place of his own. (#25)


Final Report Attachment 1: Background documents and tools · Department of Health and Ageing...

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