Better Access or better barriers? an evaluation of the Better Access initiative

The Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (BAI) initiative is the most expensive of all the programs outlined in the National Action Plan on Mental Health 2006-2011. Over the five-year period, the Federal Government committed $753.8 million to this scheme alone. Its intention: to increase access to mental health services for all Australians. Since then, costs have ballooned. The initiative is expected to cost nearly three times the initial commitment. It is important, therefore, that an evaluation is undertaken to ensure it is working effectively and efficiently. This evaluation has been the primary aim of this study. Three issues were of particular concern: firstly, whether the 2009 changes regarding eligibility requirements to access the scheme negatively affected uptake; secondly, whether the central role of General Practitioners in the scheme amounts to ‘best practice’; and thirdly, whether there was any evidence that the program had been successful in targeting vulnerable groups, with a previously low engagement with mental health services. Contrary to predictions, changes to eligibility requirements in 2009 have not negatively impacted on the accessibility of services. Results of data from Medicare Australia and the Commonwealth Department of Health and Ageing indicate that there has been an overwhelming overall uptake rate of services under the initiative. Nonetheless, there are several areas of concern. While GPs are invaluable to mental health, their central role as ‘gatekeepers’ to services may be inhibiting the efficiency of the initiative. Consistently lower access among key groups, including adolescent males; indicate a general failure to assist particularly vulnerable groups. These findings indicate that further research is required to ensure that the BAI initiative can continue to provide access to affordable mental health care beyond the 2011 end of funding commitments.