Abstract
Objective To quantify the introduction of new, temporary telehealth Medicare Benefits Schedule (MBS) items delivered by allied mental health professionals (AMHPs) through the Better Access initiative during the COVID-19 pandemic in Australia. Methods MBS-item service data for clinical psychologists, registered psychologists, social workers, and occupational therapists were extracted for existing face-to-face, remote videoconferencing and new, temporary telehealth items for the study period April-December 2020. The total number of services in Australia were compared with the baseline period of 2019. Given the second wave of increased COVID-19 infections and prolonged lockdowns in the state of Victoria, we compared the per capita rate of services for Victoria versus other states and territories. Results During the study period, there was an overall 11% increase in all allied mental health consultations. Telehealth use was substantial with 37% of all sessions conducted by videoconferencing or telephone consultations. The peak month was April 2020, during the first wave of increasing COVID-19 cases, when 53% of consultations were via telehealth. In terms of Victoria, there was an overall 15% increase in all consultations compared with the same period in 2019. Conclusions Allied mental health services via MBS-subsidised telehealth items greatly increased during 2020. Telehealth is an effective, flexible option for receiving psychological care which should be made available beyond the pandemic. What is known about the topic? Little is known about the transition to and delivery of new, temporary Better Access telehealth services by AMHPs during the COVID-19 pandemic. What does this paper add? This paper provides valuable data on the rapid transition to telehealth by AMHPs to provide levels of psychological care commensurate to 2019. Data extends from April to December 2020 and includes the overall number of services provided for each profession, and the proportion of services delivered via face-to-face and telehealth. We highlight the impact of the new, additional items which temporarily raised the cap on sessions. We also illustrate the substantial use of the scheme by those living in Victoria who experienced greater COVID-19-related hardships. What are the implications for practitioners? The continuation of Better Access telehealth services by AMHPs has the potential to extend the reach of mental health care beyond the pandemic.
Highlights
In the pandemic (March–April 2020), community studies of Australians revealed elevated depression and anxiety symptoms resulting from pandemic-induced financial stress, loneliness, and disruptions in the domains of work, leisure and relationships.[1]
What is known about the topic? Little is known about the transition to and delivery of new, temporary Better Access telehealth services by allied mental health professionals (AMHPs) during the COVID-19 pandemic
What does this paper add? This paper provides valuable data on the rapid transition to telehealth by AMHPs to provide levels of psychological care commensurate to 2019
Summary
In the pandemic (March–April 2020), community studies of Australians revealed elevated depression and anxiety symptoms resulting from pandemic-induced financial stress, loneliness, and disruptions in the domains of work, leisure and relationships.[1]. Prior to the new telehealth measures, eligible patients could receive a maximum of ten sessions of therapy per calendar year under the Medicare Benefits Schedule (MBS) Better Access initiative.[5] From 9 August 2020, the existing face-to-face and telehealth items were expanded to a maximum of 20 individual sessions each year until 30 June 2022.6 Initially the increase was approved only for people subject to public health orders restricting their movements (such as those living in Victoria), from 9 October 2020 it was extended to all eligible patients on a general practitioner (GP) mental health treatment plan (MHTP). Under the program, following an assessment with a GP, paediatrician or psychiatrist, patients can be referred for treatment with psychological therapy by clinical psychologists or for focused psychological strategies by registered psychologists, social workers or occupational therapists
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