South West is facing a mental health crisis as demand outstrips supply of psychologists in the regions

The South West is in the midst of a mental health crisis with experts saying long waiting lists, a lack of psychologists in the regions, inadequate Medicare funding and insufficient telehealth infrastructure are among the core problems. Dr Melissa Harrison owns a clinical psychology practice in Busselton and is secretary of the Institute of Clinical Psychologists, WA peak representative body for clinical psychologists. She said the first hurdle facing regional patients was the low numbers of psychologists in the region meant people were spending up to six months on waiting lists for an initial consultation. The most recent National Mental Health Workforce survey found within major cities there were 73 psychologists for every 100,000 people. “In regional areas we’re talking about 25 psychologists for every 100,000 people,” she said. This decreases even more for psychiatrists, with five psychiatrists to every 100,000 people in regional areas. “About 8 per cent of psychologists are based in regional, rural and remote areas,” Dr Harrison said. “So it gives you an indication as to how limited we are in these non-urban centres.” And remoteness further compounds the issue. “It creates a new dynamic of issues in that individuals have to travel longer distances to access services,” Dr Harrison said. “But even though we do have telehealth services available, the infrastructure is not sufficient to support that technology.” Expanded telehealth services during the pandemic have allowed psychologists to treat patients via phone consults, but Dr Harrison said once these measures were wound back in December, patients would be required to have video consults. “And that means that there are many people in more remote areas that aren’t able to access those services,” she said. But extending telehealth provisions creates a catch-22. The current increase from 10 to 20 sessions under a GP mental-health care plan means there are enough sessions for intense and evidence-based treatments, but waitlists are longer than ever. Increased awareness of mental health concerns has led more people to seek treatment during the pandemic, but psychologists are struggling to keep up with demand. “We’re finding that this is emphasising the bottleneck that has been in place for quite some time,” Dr Harrison said. She said insufficient Medicare rebates meant cost further inhibited access to mental health treatment. “When Medicare was first introduced it covered about 75 per cent of the (psychologist) fees and now it covers less than 50 per cent of the fee,” she said, adding that private health fund rebates had not increased either. “If we put that in perspective, in the 1990s private health fund rebates covered about 40 per cent of the cost, and now they cover less than 20 per cent.” She said this was making it hard for regional psychologists to maintain a viable practice. “There’s been incentives for medicine and dental (practitioners), but there hasn’t been the incentives available for psychologists to be able to effectively work in those places in a supportive fashion,” Dr Harrison said. “There’s lots that can be done to really support and sustain regional areas much better than they currently are. “It’s something that really needs State and Federal involvement to be able to resolve the issues that we’re experiencing.”