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Speaker 1: My name is Lily Maddon and I'm a proud Arunda

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Speaker 1: Bunjelung Calcuttin woman from Gadighal Country. The Daily oz acknowledges

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Speaker 1: that this podcast is recorded on the lands of the

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Speaker 1: Gadighl people and pays respect to all Aboriginal and Torres

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Speaker 1: Straight Island and nations. We pay our respects to the

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Speaker 1: first peoples of these countries, both past and present.

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Speaker 2: Good morning and welcome to the Daily Ods. It's Wednesday,

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Speaker 2: the fourteenth of December. I'm Zara, I'm sam. The federal

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Speaker 2: government has announced it will return to subsidizing just ten

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Speaker 2: psychological therapy sessions instead of twenty from next month. The

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Speaker 2: Minister for Health Mark Butler says the extra sessions were

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Speaker 2: putting more pressure on the mental health system and they

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Speaker 2: weren't benefiting disadvantaged Australians.

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Speaker 3: At white times blew out for everyone, more so for

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Speaker 3: the lowesting come Australians.

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Speaker 4: But psychologists have criticized the move.

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Speaker 5: We are absolutely devastating, we are shocked.

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Speaker 2: We also put out a call on Instagram and have

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Speaker 2: been inundated with responses, so we'll look at those as well.

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Speaker 4: But as always, let's start with the headlines.

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Speaker 6: Prime Minister Anthony Albanezi has paid tribute to the victims

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Speaker 6: killed in a shootout in rural Queensland on Monday.

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Speaker 7: All Australians are shocked and saddened by this tragic loss

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Speaker 7: of life. Two Queensland police officers their lives cut short

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Speaker 7: by this atrocity.

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Speaker 6: The incident occurred in the Western Downs region of Queensland.

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Speaker 2: Sam Bankman Freed, better known as SBF, who was the

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Speaker 2: founder and former head of the FTX crypto exchange, has

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Speaker 2: been arrested in the Bahamas at the request of the

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Speaker 2: US authorities. We've spoken about SBF and the collapse of

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Speaker 2: his cryptocurrency exchange before on the pod.

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Speaker 4: There's a link to that deep dive in the.

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Speaker 2: Show notes, but the latest is that it's expected he'll

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Speaker 2: be extradited back to the US.

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Speaker 6: US President Joe Biden has announced a new government group

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Speaker 6: to improve efforts against anti Semitism, Islamophobia and other forms

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Speaker 6: of discrimination. The group will be led by two US

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Speaker 6: government agencies and will be initially tasked with developing a

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Speaker 6: national strategy to counter antisemitism.

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Speaker 2: And the good news, retired tennis player Ash Barty has

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Speaker 2: won tennis Australia's newcom medal for twenty twenty two and

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Speaker 2: she has become the first person to do so five times.

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Speaker 2: Barty walked away from professional tennis back in March this year,

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Speaker 2: but she's been rewarded for her efforts at the Australian Open,

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Speaker 2: which she won for the first time in her.

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Speaker 4: Career earlier in the year.

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Speaker 2: So earlier in the week, we had an announcement that

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Speaker 2: from January first, the government will go back to subsidizing

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Speaker 2: just ten psychological therapy sessions instead of twenty. Safe to

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Speaker 2: say that this is really struck a chord with the

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Speaker 2: TDA community.

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Speaker 6: Yeah, we've been inundated with messages. But before we get

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Speaker 6: into this story, can we explain what the subsidy actually

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Speaker 6: is and how it works.

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Speaker 2: Well, the government has subsidized mental health treatment plans and

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Speaker 2: therapy sessions under a program called Better Access since two

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Speaker 2: thousand and six. To access these subsidized sessions, you need

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Speaker 2: to get a mental health plan, which you can get

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Speaker 2: through your GP and then the subsidy is provided through Medicare,

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Speaker 2: but providers can charge and often do charge a fee

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Speaker 2: on top of the subsidy amount, and we call that

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Speaker 2: a gap fee. So Medicare is covering some of it,

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Speaker 2: but definitely in most cases not all of it.

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Speaker 6: And we've talked about our psychological systems on this podcast before.

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Speaker 6: What's changed this week.

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Speaker 2: So, prior to the pandemic, you could access ten subsidized

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Speaker 2: sessions from the government. But during COVID the Coalition government

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Speaker 2: increased the number of subsidized sessions from ten to twenty

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Speaker 2: and that scheme was due to expire on the thirty

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Speaker 2: first of December this year, and so the announcement that

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Speaker 2: we heard from the federal government this week was that

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Speaker 2: they won't be extending those twenty sessions past that point.

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Speaker 2: The government has clarified though that any patients with a

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Speaker 2: current mental health treatment plan that includes a referral for

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Speaker 2: ten additional sessions, they'll still be able to access those

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Speaker 2: into twenty twenty three if it's been set up already.

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Speaker 6: That's a pretty major change to the way that psychological

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Speaker 6: sessions are structured in Australia.

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Speaker 2: What's the reason for this, Well, they say it was

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Speaker 2: based on a review of the mental health system done

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Speaker 2: by the University of Melbourne.

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Speaker 3: Broadly speaking, the evaluation finds that this program is very

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Speaker 3: widely used and outcomes from the program are largely positive.

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Speaker 2: That's Health Minister Mark Butler releasing the review this week.

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Speaker 3: It also found that all of the growth, all of

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Speaker 3: the growth in services went to the highest income Australians,

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Speaker 3: with the lowest income Australians actually receiving fewer services over

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Speaker 3: this period than they had before the introduction of.

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Speaker 6: The additional ten.

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Speaker 2: The Health Minister was saying that for economically disadvantaged groups,

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Speaker 2: the extra sessions were actually making things worse rather than better.

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Speaker 3: It found that those additional ten aggravated existing wait lists

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Speaker 3: and aggravated barriers to access, particularly by the groups that

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Speaker 3: I've mentioned.

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Speaker 2: I think it's worth noting, though, that the reviews that

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Speaker 2: the Minister is referring to doesn't actually recommend scrapping the sessions.

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Speaker 2: He recommended keeping them, but with additional measures to better

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Speaker 2: target who was accessing them.

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Speaker 6: And I think those additional measures are worth explaining. But

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Speaker 6: first take me through the opposition response to this.

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Speaker 2: Well, we had shadow Health Minister and Rustin criticized the

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Speaker 2: government's decisions, saying, with everything going on right now, natural

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Speaker 2: disasters are cost of living crisis, the government's decision is staggering.

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Speaker 2: That's the word she used, and she made this point

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Speaker 2: when she spoke on Sky News.

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Speaker 8: Yeah, the government really needs to come clean with why

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Speaker 8: it's made a decision at this time when we know

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Speaker 8: that people are still very much in need of the

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Speaker 8: supports that have been provided by these additional psychology sessions.

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Speaker 6: When we put the call out to our audience, we

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Speaker 6: had a huge number of responses. What was the general

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Speaker 6: sentiment amongst the audience, Sarah.

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Speaker 2: The majority of our audience were unhappy with the government's decision,

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Speaker 2: and we've got quite a few messages that were of

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Speaker 2: the same kind of tone. I'll read one of them

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Speaker 2: out now, because I thought that this one really struck

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Speaker 2: a chord. This person said, I've dipped into my very

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Speaker 2: small savings pool and received financial assistance from family members to.

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Speaker 4: Be able to afford the full price sessions.

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Speaker 2: Over the past six months, every time my bank account

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Speaker 2: was overdrawn, I would remind myself that I just have

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Speaker 2: to hang in there until January when I can access

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Speaker 2: the subsidy on a mental health care plan.

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Speaker 4: Again.

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Speaker 2: I was truly hanging out for the reprieve of twenty

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Speaker 2: subsidized sessions. I know that so many Australians will be

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Speaker 2: feeling the pressure from this. We also got other messages

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Speaker 2: that showed a different perspective. One person wrote, from experience,

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Speaker 2: I found that seeking psychological support is still financially prohibitive

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Speaker 2: even with the subsidy. I couldn't afford more than three

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Speaker 2: appointments with the subsidy. Ten appointments with a larger subsidy

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Speaker 2: would be better than twenty appointments that you still have

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Speaker 2: to pay one hundred dollars for. And that person there

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Speaker 2: is referring to that gap fee we've spoken about. They

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Speaker 2: went on to say not many people have the ability

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Speaker 2: to use twenty appointments and then pay the gap. So

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Speaker 2: while on the surface it sounds bad to reduce the

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Speaker 2: number back to ten, the current system is not set

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Speaker 2: up to allow people to use all twenty even if

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Speaker 2: they were available.

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Speaker 6: There's some really interesting ideas they're raised by our audience.

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Speaker 6: You also spoke to a psychologist. What did she have

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Speaker 6: to say?

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Speaker 2: So I spoke to Sarah O'Doherty. She's a director on

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Speaker 2: the board of the Australian Association of Psychologists and she's

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Speaker 2: also a psychologist herself, practicing in Sydney, so she's fairly

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Speaker 2: across the issues that are facing the mental health system.

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Speaker 2: At the moment I asked her how she feels about

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Speaker 2: this announcement to return to those ten subsidized sessions.

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Speaker 5: Absolutely devastated. We are shocked because we have promoting the

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Speaker 5: idea of getting help for yourself, accessing psychology services throughout

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Speaker 5: the pandemic and even before that. But now it's a

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Speaker 5: scarcity issue. I mean ten sessions really, I see clients fortnightly.

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Speaker 5: Clients can blow through ten sessions in under six months.

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Speaker 5: So if that is the case, then we're not going

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Speaker 5: to be able to provide effective long term care when

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Speaker 5: those people need it. And we're also really angered by

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Speaker 5: this decision because it actually goes against what the Better

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Speaker 5: Access Evaluation recommendations were.

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Speaker 2: And that's the report that the Minister reference when he

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Speaker 2: made his announcement. So what did the report actually recommend.

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Speaker 5: Recommendation twelve in that report actually stated that the additional

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Speaker 5: ten sessions, so the twenty sessions per calendar year, should

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Speaker 5: be continued for the benefit of all people accessing mental

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Speaker 5: health support in Australia.

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Speaker 2: What the Health MANA Mark Butler, did say earlier this

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Speaker 2: week was that the extra ten sessions had quote aggravated

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Speaker 2: existing weightlists and aggravated barriers to access.

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Speaker 4: What would you say to.

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Speaker 5: That, I would say that there has always been a

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Speaker 5: weight list problem in Australia, particularly in the last few years.

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Speaker 5: There has been a mental health crisis since the pandemic started,

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Speaker 5: which has actually meant that a lot of people, particularly

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Speaker 5: young people, are accessing psychologists for the first time and

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Speaker 5: because of this influx of demand. We absolutely disagree with

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Speaker 5: the decision that cutting services is the right thing to do.

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Speaker 2: We do know though, that waitlists and how long they

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Speaker 2: are is a big problem. So what do you see

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Speaker 2: the remedy to that being So.

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Speaker 5: The AAPI has a few different suggestions and advocacy points

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Speaker 5: that we have been pushing. The first of which is

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Speaker 5: we need to have more psychologists who are going to

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Speaker 5: be able to provide these services. So what we're proposing

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Speaker 5: is we have seven thousand, nine hundred provisional psychologists who

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Speaker 5: are already working with the Australian public. They are in

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Speaker 5: the very very last stages of their training and they

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Speaker 5: are receiving huge amounts of supervision. As I said, they're

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Speaker 5: already working in places like public hospital systems and in

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Speaker 5: private practices, but they're not eligible for a Medicare rebate.

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Speaker 5: So they can't offer Medicare rebates to the Australian public.

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Speaker 5: What we're suggesting is that if we were able to

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Speaker 5: give if the government was able to give those seven

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Speaker 5: nine hundred psychologists provisional psychologists the ability to give a

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Speaker 5: Medicare rebate to their existing patients and new patients, we

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Speaker 5: would solve this problem hugely.

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Speaker 2: So, just to clarify, you're saying that bolstering the workforce

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Speaker 2: by introducing new sites to that existing workforce could see

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Speaker 2: that pressure on waiting lists diminish.

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Speaker 5: Absolutely it would. And the other thing that the Better

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Speaker 5: Access Evaluation has shown us by far what it said

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Speaker 5: was the reason why a lot of people are not

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Speaker 5: able to access psychologists is a cost factor. And I

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Speaker 5: think cutting the Medicare rebated sessions from twenty sessions per

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Speaker 5: year to ten is going to mean either a lot

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Speaker 5: of people are going to be missing out on those

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Speaker 5: additional sessions because they're not going to be eligible for

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Speaker 5: that rebate, or they're going to have to pay privately,

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Speaker 5: which means other things like the cost of living issues

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Speaker 5: that we're having at the moment in this country are

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Speaker 5: going to be even more stretched. People are going to

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Speaker 5: have to choose between going to see their psychologist or

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Speaker 5: having a grocery shop done or their rent being paid.

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Speaker 4: Picking up on that cost of living point.

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Speaker 2: The Health Minister also said that the benefits of those

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Speaker 2: extra ten sessions were going to the highest income Aussies

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Speaker 2: and not the disadvantage groups.

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Speaker 4: How would you respond to that.

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Speaker 5: I would respond that we've actually seen a huge influx

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Speaker 5: in people who are accessing these services in regional and

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Speaker 5: rural areas. But again, I feel like the major issue

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Speaker 5: here is we're not having enough psychologists in those areas

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Speaker 5: serving those populations. So what we're finding is obviously the

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Speaker 5: majority of psychologists are going to be located in the

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Speaker 5: big metropolitan cities. And what we actually need, and what

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Speaker 5: the Australian Association of Psychologists is proposing, is that we

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Speaker 5: have something similar to what GPS have where there is

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Speaker 5: an incentive for psychologists to be placed for medium to

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Speaker 5: long term in some of those regional and rural areas.

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Speaker 5: We also have partnered with universities to be able to

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Speaker 5: provide supervision to psychologists from those regional and rural areas

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Speaker 5: so that they can stay in their hometowns and they

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Speaker 5: can have a living providing really good psychology services to

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Speaker 5: their communities.

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Speaker 2: Okay, so to me it sounds like both workforce and

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Speaker 2: then getting psyches out to those rural and regional areas

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Speaker 2: could be one way to solve at least some of

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Speaker 2: the problem. What else can be done though.

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Speaker 5: So the other big advocacy issue that the Australian Association

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Speaker 5: of Psychologists has is we need to increase the Medicare

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Speaker 5: rebate for all psychologists for all patients accessing a psychologist.

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Speaker 2: Can you just run through what that rebate looks like

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Speaker 2: in case people haven't accessed that before.

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Speaker 5: Absolutely so. At the moment, the Medicare rebates for the

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Speaker 5: majority of psychologists is around eighty nine dollars. For a

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Speaker 5: few psychologists who have a particular kind of endorsement, they

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Speaker 5: are able to provide a rebate of about one hundred

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Speaker 5: and thirty dollars, But that's only about twenty five to

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Speaker 5: thirty percent of the psychology workforce, So the majority of

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Speaker 5: psychologists who are out there provide a rebate of eighty

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Speaker 5: nine dollars. What we found with our research was that

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Speaker 5: the average session fee for a psychologist is between one

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Speaker 5: hundred and sts seventy nine and two hundred dollars per session,

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Speaker 5: so it's roughly one hundred bucks out of pocket that

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Speaker 5: the public has to pay per session. What we're advocating

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Speaker 5: for is for the rebate to be raised to one

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Speaker 5: hundred and fifty dollars, which means I would bulk bill,

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Speaker 5: a lot of other psychologists would bulk bill, And what

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Speaker 5: that means is that a lot of people would be

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Speaker 5: able to access psychologists without a gap payment, or if

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Speaker 5: there are psychologists who are in higher socioeconomic areas, there

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Speaker 5: might be a much much lower out of pocket cost.

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Speaker 5: But I think that increasing the rebate is going to

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Speaker 5: make sure that the affordability issue and the access and

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Speaker 5: equitability issue of the better Access program. I mean, it's

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Speaker 5: called better Access. We're wanting to improve that for all people,

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Speaker 5: particularly those who feel like they can't access it. At

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Speaker 5: the moment, do.

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Speaker 2: You feel like the government is actually receptive to this

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Speaker 2: sort of feedback.

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Speaker 5: I would absolutely hope that they are, But at this point,

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Speaker 5: I'm just not sure. It seems like they have made

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Speaker 5: their decision, and you know, I think that they really

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Speaker 5: do need to listen to this feedback from the public

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Speaker 5: and from the profession.

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Speaker 2: Yeah, we did a call out and we are just

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Speaker 2: getting overwhelmed with a number of messages of people just

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Speaker 2: in utter despair.

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Speaker 5: So absolutely, it's so sad. I'm so angry about this.

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Speaker 5: Thank you so much for your time, Sara, You're very welcome.

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Speaker 6: Zarah, thank you for joining us on the daily ours,

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