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Mental health rebate may blow hole in budget, -

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Reporter: Jennifer Macey

PETER CAVE: With the many people losing their jobs, or facing the prospect of unemployment -
there's been a big jump in the number of people seeking help for mental health problems.

The Mental Health Care Council of Australia says spending on the Medicare rebate for mental health
consultations has increased by 40 per cent.

The rebate has already exceeded its annual budget and there's concern that the rebate may not be
reaching those people who need it the most.

Jennifer Macey reports.

JENNIFER MACEY: Every month, psychologist Dr Leigh Hodder flies to Biloela and Emerald in regional
Queensland to see patients suffering from depression and anxiety.

In the past few months she's seen a big jump in the number of referrals from local GPs and Dr
Hodder is blaming the global financial crisis that's already led to thousands of job losses in some
mining communities.

LEIGH HODDER: Particularly in the rural and remote areas because I deal with a lot of mining
communities and as we know, they have shed at least 5,000 jobs up here in Queensland. You know with
the farmers, when I first started seeing them it was primarily to do with the drought etc but now
there is just so much financial pressure on everybody in those rural and remote areas.

I also see people in the city and their concerns are pretty much the same - redundancies, cutbacks,
how are we going to pay for the groceries, how are we going to buy the kids their shoes and their
books and all this sort of stuff.

So it is really hitting people quite hard.

JENNIFER MACEY: This anecdotal evidence is reflected in the official Medicare figures.

The Mental Health Council of Australia says the number of people claiming the rebate for mental
health consultations has jumped by about 40 per cent compared to last year.

The council's CEO is David Crosbie:

DAVID CROSBIE: This has been a massive uptake of new MBS service items since it started in late
2006 - much higher than anyone anticipated and certainly much higher than was initially anyone
budgeted for.

JENNIFER MACEY: To access the Medicare rebate, patients first need to get a referral from a GP who
prepares a mental health care plan. This costs Medicare $150 for each plan.

Since the scheme was introduced in 2006, over one million have been written - although not everyone
has followed up on the referrals.

David Crosbie says the Federal Government has underestimated the cost of providing mental health
care services through Medicare.

DAVID CROSBIE: For the current financial year, the budget in the original estimate was about
$108-million. What we expect the actual to be is well over $300-million - so three times as high as
that and if it continues to grow the way it is, we would expect that expenditure, you know, within
a couple of years will be over half a billion dollars on these three measures alone.

JENNIFER MACEY: And he's not certain that the Medicare rebate has been the best way to address the
problem of mental health in Australia.

DAVID CROSBIE: Really only about a third of people who experience mental health problem in any
given 12-month period will actually get services. So there is huge unmet demand.

The question is do these services, as they are currently constructed, meet that demand and have
they increased access or have they allowed people who were previously getting counselling or
previously seeing their GP for these kinds of issues to simply have access to a new range of
Medicare benefit rebates.

JENNIFER MACEY: Many mental health care professionals also doubt whether the Medicare rebate is the
best use of federal government money.

Jeff Cheverton is the CEO of Queensland Alliance which represents the mental health community
sector in Queensland.

JEFF CHEVERTON: One of the questions would have to be whether accessing psychological therapies
through general practice is the most efficient route. Another alternative would be to look at
people being able to go directly to psychological services rather than general practice acting as a
gatekeeper.

We have very little health promotion in Australia. If you look to New Zealand or to the UK, you
will see a lot of public mass media advertising that is explaining to people how they can maintain
their own mental health.

Now obviously for people with very severe conditions, they are still going to need medical
treatment and access to GPs and access to psychological therapies; but for many, many people, if we
simply give people basic information about how to stay well and promote mental health, then they
may never get to the point of needing these types of services.

JENNIFER MACEY: The World Today sought comment from the Federal Health Minister Nicola Roxon, but
she was unavailable.

PETER CAVE: Jennifer Macey with that report.