Medicare Funded Mental Health Social Work: Better Access to What?

Abstract

ABSTRACTBetter Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Scheme initiative (Better Access), is an Australian Federal Government scheme aiming to improve access to mental health services. Accredited mental health social workers have been involved in the delivery of services under Better Access for more than a decade. In this time, there have been significant changes in the field of mental health services, with consequent increases in size and costs for Better Access. Better Access now represents public spending of more than one billion dollars per annum, yet there is no ongoing account of its impact. In this paper we consider the policy chronology and evaluation of the program, using current available data to question the impact of Better Access on both the service system and the nature of mental health social work practice. This case highlights the importance of a clear articulation of the scope of mental health social work, and ongoing monitoring of the impact of policy in a policy environment increasingly characterised by individualised funding and service delivery structured according to the principles of New Public Management.IMPLICATIONSSocial workers' increasing involvement with Better Access has reshaped the scope of mental health social work practice.The impact of Better Access on outcomes for service users and mental health social work is not currently a focus of research attention.Better Access is a case study illustrating the potential of the policy context to directly shape social work practice, therefore critical engagement with the impact of Better Access is an essential professional imperative.