Geographic inequity in access to mental health services never starker

4 minute read

New data maps the postcode lottery dictating how Australians access mental health care. And employment is crucial.

Basic inequity between city and country when it comes to access to mental health services has once again been highlighted in the latest report from Mental Health Australia.

Despite significantly higher rates of long-term mental health conditions in regional, rural and remote Australia compared with major cities, distressed people in the bush are using Medicare-subsidised mental health services half as much.

“It is completely unacceptable that some people who are more likely to experience high psychological distress and mental health conditions have less access to the services and supports they require,” said Carolyn Nikolosi, CEO of Mental Health Australia.

“Government data shows there are nearly twice the number of psychologists per 100,000 population in major cities compared to regional areas, and more than twice as many psychiatrists. Our policymakers should be working towards eliminating this divide.”

The Mapping Mental Health Care report was released by MHA yesterday.

It showed that in major cities, 21.81% of the population have long-term mental health conditions. That rate climbs to 28.69% as rurality increases to remote Australia. By stark contrast, 11.76% of people in major cities access Medicare-subsidised mental health-specific services, compared with just 5.15% in very remote Australia.

“The data also reveals the use of Medicare-subsidised mental health services is almost twice as high in affluent socioeconomic areas such as Sydney’s Eastern Suburbs North region (15%), compared to lower socioeconomic areas such as Auburn in Western Sydney (7%), despite higher estimated rates of psychological distress and mental health conditions,” said the report.

Ms Nikoloski said MHA was calling on the government to work closely with the sector, and with people with lived experience and their family and carers, on the development and implementation of a multi-year mental health reform roadmap.

“Mental Health Australia welcomes Minister Butler’s attention to inequity in the mental health system in the wake of the Better Access evaluation, but now we need action.

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“Through the roadmap, the Australian Government should ensure all people in Australia can get support for their mental health early, before problems snowball, by increasing access to early intervention and digital mental health supports.

“People should be able to access appropriate support, regardless of income or postcode,” said Ms Nikoloski.

The research also highlights specific demographic groups experiencing high psychological distress and mental health conditions.

It shows that 38% of unemployed people experience “high psychological distress”, as do 35% of people in a single parent household; and 29% of people aged 15 to 24 years.

Thirty-nine percent of Australians in single-parent households and 37% of unemployed people have long-term mental health conditions.

At the National Employment Services Association Conference today, Professor Ian Hickie, co-director of University of Sydney’s Brain and Mind Centre, highlighted the critical importance of employment as a protective factor against mental health problems.

“We know that work is a protective factor for good mental health and being out of work puts people at risk of depression, anxiety and lower self-esteem,” said Professor Hickie.

“It’s already difficult for the average job seeker and even harder for Australians who are behind the eight ball because they are facing entrenched disadvantage.

“This can include limited education, being a young person with litle work experience, living with a disability or health issue, having a criminal history, or coming from a background of intergenerational unemployment.

“It’s critical that we develop pathways to help people gain security in employment and to encourage more inclusive and accommodating job design and workplace practices.”

Professor Hickie said it was also important to debunk the myth that people with a mental health issue such as depression need time off work to get well.

“The truth is we don’t get well to go to work – we go to work to get well,” he said.

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