National mental health report 2013

Medicare Benefits Schedule funded private mental health care

Page last updated: 2013

Most previous National Mental Health Reports confined their coverage of Medicare Benefits Schedule (MBS) funded services to the activities of consultant psychiatrists working in the private sector. The 2010 report extended this scope to incorporate new MBS‑subsidised services provided by general practitioners and allied health professionals that were introduced through Australian Government initiatives under the 2006 National Action Plan on Mental Health.

These services became available through the initiative known as Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access), which was introduced in November 2006 in response to low treatment rates for common mental disorders (for example, anxiety, depression and substance use disorders). Better Access introduced a series of new item numbers on the Medicare Benefits Schedule to provide a rebate for selected services provided by general practitioners, psychiatrists, psychologists, social workers and occupational therapists.

Figure 35 shows that MBS expenditure on mental health services has increased significantly in line with the introduction of Better Access. In 1992‑93, an estimated $521 million was spent on MBS‑funded services, accounted for by services provided by GPs and consultant psychiatrists. This figure rose incrementally until the mid‑1990s, reaching $576 million in 1995‑96, and then dipped into the mid‑2000s. In 2007‑08, the first full year of Better Access, expenditure rose to $583 million and by 2010‑11 the overall MBS mental health specific expenditure figure reached $852 million, accounting for 35% of overall Australian Government mental health spending.

Figure 36 shows the distribution of expenditure across the different provider groups over time. In 1992‑93, services provided by psychiatrists and general practitioners accounted for 57% and 43% of overall MBS expenditure on mental health services, respectively. As Better Access was rolled out in 2007‑08, the share of expenditure on services delivered by psychiatrists and general practitioners in that year reduced, with the former accounting for 43% and the latter tallying 25%. In that year, 13% of expenditure covered services delivered by clinical psychologists, and 19% covered services delivered by registered psychologists and other allied health professionals. The proportion of expenditure dedicated to services delivered by each of these groups has continued to grow, and in 2010‑11 it collectively made up 41% of all expenditure on MBS‑funded mental health services.

In total, one million people received mental health services subsidised by the Medicare system in 2007‑08 (see Figure 37). This number climbed steadily during the first five full years of Better Access, and reached 1.6 million in 2011‑12.

Figure 38 provides a breakdown of the number of people seen by psychiatrists, general practitioners, clinical psychologists and other allied health professionals in 2011‑12. Some of the individuals treated by MBS‑subsidised mental health service providers in 2011‑12 received services from more than one kind of provider, so the total exceeds 1.6 million. General practitioners saw the largest number of people (1.2 million), which reflects the fact that they not only provide mental health services themselves but also act as the referral conduit to other providers under the rules of Better Access. Registered psychologists and other allied health professionals saw nearly 500,000 people.

In total, 7.9 million mental health services were provided through Medicare in 2011‑12, compared with 3.3 million provided in 2006‑07 (an increase of 141%). Figure 39 shows the number of services provided by each of the four provider types, and demonstrates significant growth for services provided by general practitioners (0.6 million to 2.2 million), clinical psychologists (0.2 million to 1.4 million) and other allied health professionals (0.5 million to 2.3 million). Figure 39 suggests that in all three cases the growth is beginning to attenuate and that for other allied health professionals it may be beginning to reverse. An evaluation of Better Access suggested that the significant initial uptake of these new services reflected the high levels of previously unmet need for mental health care in the community.31

Figure 35: MBS expenditure on mental health services ($millions), 1992-93 to 2010-11

Refer to the following text for a text equivalent of Figure 35: MBS expenditure on mental health services ($millions), 1992-93 to 2010-11

Text version of figure 35

Expenditure:
  • 1992-93 - $521M
  • 1993-94 - $550M
  • 1994-95 - $560M
  • 1995-96 - $576M
  • 1996-97 - $561M
  • 1997-98 - $551M
  • 1998-99 - $541M
  • 1999-2000 - $534M
  • 2000-01 - $527M
  • 2001-02 - $514M
  • 2002-03 - $491M
  • 2003-04 - $477M
  • 2004-05 - $491M
  • 2005-06 - $509M
  • 2006-07 - $474M
  • 2007-08 - $593M
  • 2008-09 (first full year of Better Access) - $694M
  • 2009-10 - $768M
  • 2010-11 - $852M Top of page

Figure 36: Distribution of MBS expenditure on mental health services, 1992-93 to 2010-11

Refer to the following table for a text equivalent of Figure 36: Distribution of MBS expenditure on mental health services, 1992-93 to 2010-11

Text version of figure 36

1992-93 (%)2007-08 (%)2010-11 (%)
Psychiatrists
57
43
32
General practitioners
43
25
27
Clinical psychologists
0
13
18
Other allied health professionals
0
19
23
Top of page

Figure 37: Number of people treated by MBS-subsidised mental health service providers, 2006-07 to 2011-12

Refer to the following text for a text equivalent of Figure 37: Number of people treated by MBS-subsidised mental health service providers, 2006-07 to 2011-12

Text version of figure 37

  • 2006-07 - 648,987
  • 2007-08 (first full year of Better Access) - 1,006,985
  • 2008-09 - 1,224,940
  • 2009-10 - 1,366,185
  • 2010-11 - 1,522,720
  • 2011-12 - 1,602,612 Top of page

Figure 38: Number of people treated by MBS-subsidised mental health service providers, by provider type, 2011-12

Refer to the following text for a text equivalent of Figure 38: Number of people treated by MBS-subsidised mental health service providers, by provider type, 2011-12

Text version of figure 38

  • Psychiatrists - 305,170
  • General practitioners - 1,248,735
  • Clinical psychologists - 281,915
  • Registered psychologists and other allied health professionals - 497,952 Top of page

Figure 39: Number of MBS-subsidised mental health services provided, by provider type, 2006-07 to 2011-12

Refer to the following table for a text equivalent of Figure 39: Number of MBS-subsidised mental health services provided, by provider type, 2006-07 to 2011-12

Text version of figure 39

2006-072007-082008-092009-102010-112011-12
Psychiatrists
1,986,533
1,949,702
1,967,222
1,983,481
2,009,411
2,058,777
General practitioners
618,915
1,257,962
1,622,347
1,835,094
2,131,299
2,194,530
Clinical psychologists
189,946
649,377
904,835
1,087,169
1,270,250
1,378,089
Registered psychologists and other allied health professionals
478,956
1,323,166
1,734,728
2,082,807
2,337,592
2,302,879