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Unfortunately Australia, unlike Europe, Asia, Africa and the Americas, fails to utilise and really recognise the many thousands of psychotherapists, clinical counsellors as well as alternative modes of healers (e.g. energy healing) where professionals train for many years before treating mental health conditions. The fact is that the rates of mental health remain stubbornly high and we are reminded of this fact almost daily through media sources. Medicare benefits need to be opened to a wider field of professions (more than psychiatrists and psychologists) which would enable those who need it the most e.g the client, to have a greater range of treatment and options at their disposal. This requires insight, flexibility and knowledge from our medical policy makers who work from a very narrow paradigm which is reflected in the state of our countries mental health crisis.

Oh boy I have a lot of thoughts around this. Firstly, bulk-billing is only a small piece of the puzzle. We simply don’t have enough psychologists, and they are not the only ones who can help. It’s a huge shame that counsellors in Australia are not Medicare rebatable, considering many of us use the same therapies that psychologists do and have the same ability to help. While I acknowledge some of our roles are also different, we are also credible experts in mental health in our own ways and should be a part of the system. There are currently thousands of registered, trained counsellors who are able to be utilised immediately to help with this crisis, and yet currently Medicare does not allow us to bulk-bill. Furthermore, while adding provisional psychologists might seem like an easy fix, provisional psychologists still need to undertake supervision in their training; if we don’t have enough qualified psychologists to deal with this mental health crisis, who exactly is going to supervise provisional psychologists and make sure they’re utilising best practice? Fully registered counsellors should be part of solving this issue.

The approach to mental health needs to be seen as a concurrent approach with physical condition issues. The current medical approaches to mental health require an overhaul, with the focus being on patient outcomes not financial positions and ability. We don't address the crux issues and nor do we give long term real solutions in the current practices. When we fail to treat the human as a whole, we fail to treat the human. With a financially driven focus approach to how to heal someone, we already fail at the outset ethos.

I can’t speak for psychology, but in general practice, the state of bulk billing rebate and expectation that the GP will not charge more has been the instigator of the cosmetic cowboy disaster we are currently facing. GP’s breaking free of the inadequate Medicare rebates into an area where Medicare is not involved. How does the government think that a medical graduate seeing a patient for a Medicare rebate of $17.50 (!!!) is reasonable? It’s a farce. Then they want them to do 5 extra years so they can get $35 or so for a consult. Then we wonder why they zoom off to learn how to do breast jobs, Botox, collagen fillers and Brazil Butt lifts. Took my dog to the vet it cost $250.

All medical professionals should  have access to more money from medicare.  At the moment, it is very difficult to operate on what the government provides.  High income earners should be forced to take out private insurance 

A core issue that urgently requires attention is the serious lack of counsellors available to meet the current and future growing demands. As long as the AAPi continues to block other experienced and equally or more qualified counsellors offering the rebate then all this debate is doing is shifting the chairs in the Titanic.... as the system stinks to the bottom. As a Clinical Family Therapist i am swamped with referrals who say they can't find a psychologist without a wait list of a least 6 months. However even though I charge less than a psyc they still cannot afford counselling as there is no rebate. AAPI it's time to wake up, act maturely and speak with other counselling peaks such,  AAFT, ACA and PACFA, you are not the only holder's of wisdom, experience, qualifications, knowledge and solid counselling skills. Again WAKE UP, all those who require counselling deserve a mature and balanced consideration to resolve this issue. Then we can all together advocate for reasonable fees. 

I work in health but I also have sons who have sadly been in and out of psychologist care for over a decade. Money has always been an issue. Most psychology appointments are at least an hour in duration. Our costs are generally around $50-$70 out of pocket on top of the Medicare amount. Your heart sinks when the psychologist tells you they will need a few weeks of twice weekly sessions because of an exacerbating incident as it just rips a huge hole in your budget. Then you feel guilty about worrying about money when your kids are sick enough to need that level of care. We tried moving to the public system but after only a couple of months we were basically told that - one son should just 'be normal', and with the second son he was being discharged because 'the practitioner was being moved back to inpatient care so a lot of her patients were being discharged'. That second son told me in the car afterwards how he had made plans to commit suicide but hadn't told the practitioner as he didn't want her to worry about him when she left! Needless to say it was back to the private system and pulling money out of the mortgage to cover the extra costs. Luckily we had a mortgage that allowed us to do that. Terrible for parents that can't.

I have been a clinical mental health clinician for 18 yrs. Public System Community Mental Health Service out service is free. I absolutely support increased bulk billing funding for GPs. Unfortunately I do not support an increase for psychologist. It has been my repeated experience that the MHCP sessions with psychology does not provide value for money. Clients often come back to us bewildered as to why they were referred to psychologist nothing achieved. The tax funds would be better spent Public Housing, and anti poverty programs,delivery of a living wage, advocacy programs re Centrelink welfare rights programs. MH starts with Primary Health so funding dietitians, physio, fitness trainers, dentistry, childcare have a far bigger impact in reducing the stressors of clients accessing MH services than 6 sessions with a Psychologist.  Psychologist close the clients therapy sessions if the clients become mentally unwell and return them to the public system instantly. A Public System which is under funded with funds being directed to private practice for profit  psychology. For example psychology under the current system do nothing to impact on suicide prevention. Having practiced for 18yrs in MH this is an informed response to your question. GPs need an increase in BB funds, however psychologist do not in my informed opinion do not. It's a free market based system so those psychologist who are unable to provide outcomes for the funding provided are a failed business they do not need more funding they need to close and allow the funding to go to psychological services that are getting practical outcomes. I would recommended a consumer evaluation and GP outcomes evaluation before they get paid.cheers Kym

Bulk billing rate is too low and needs to be raised for all services across the board. Degree of access to rebates should be scaled, so those who can afford to pay more do and more money is left in the pot for those who can’t so the overall rebate is higher. Practitioners can control who they see and if they want to charge gap fees. So, without higher bulk billing rebates for practitioners, they are less likely to give clients the same degree of time and care, offer fewer BB consults and access to care for those who need it, but can’t afford to pay for it will only decline. There should also be a look at how other services can be involved like counsellors, group sessions, online and community groups and forums as there are multiple ways of getting information to patients that are less costly for practitioners but can still offer high value. Greater effort also needs to be made to address fundamental health issues at ground roots levels that have potential to help most people like: -better management of pain and chronic health conditions -how and where to get financial help  -meeting basic needs of somewhere safe to sleep and access to nutrition/hydration and what these should look like vs maccas diet.   and so on.  A big issue with mental health is that it can interfere with every aspect of life including being able to find help, manage the complexities of Centrelink and have enough money to survive from day to day. There needs to be better access to emergency care separate from EDs, earlier identification of issues and emotional management toolkits taught earlier perhaps in schools. I don’t think the issue is just the access and practitioners being able to make a reasonable wage that matches their expertise, it’s also what is causing so many people to need help and what can be done earlier and better so fewer people need to seek care and then those who do need it can easily access it quickly and affordable.