Telehealth video psychiatry return a step in the right direction, still more to be done

Lived Experience Australia (LEA) welcomes the Government’s announcement of restoring bulk billed Medicare Benefits Schedule (MBS) psychiatry services delivered by video telehealth to rural and regional Australians.

This decision will benefit the 28% of Australians who live outside metropolitan cities, who have experienced many challenges in accessing even basic health care and mental health care for decades. These challenges have contributed greatly to poorer health outcomes across multiple areas of concern for people living in rural areas. 

However, it doesn’t address the need for those in metropolitan areas who experience similar affordability and access issues, by virtue of their circumstances at home (for example, family violence, isolation, social exclusion, stigma and discrimination when seeking service support). These people would benefit greatly from the same level of telehealth access and support.

In August 2022, LEA partnered with the National Association of Practising Psychiatrists (NAPP) in a joint submission to the Health Ministers, raising our concerns from a lived experience perspective about the cessation of the Medicare item 91840 – a longer consultation delivered by telephone. In that submission, LEA provided several testimonials from those with lived experience of mental ill-health describing how this telephone consultation was not only vital in averting further crisis and potential hospital admission, but was for some the only practical way of connecting with safety and reliability.

In a study undertaken by LEA in February 2021, people with lived experience of mental ill-health advised that the telephone option allowed them to feel safer and more equal in the relationship with their psychiatrist in discussions about their care. Importantly, it afforded them the privacy to discuss their concerns, particularly where they lived with others. Family carers told LEA that telephone contact was less threatening and more practical, particularly when their loved one was distressed or experiencing paranoia and may be unable to sit in front of computer screen for long.

Lived Experience Australia Chair and Executive Director, Sharon Lawn says: “It’s clear that ensuring more telephone options in the suite of available supports – in addition to the video options reinstated recently – is trauma-informed and more inclusive for all those who need support, regardless of where they live in Australia.”

This statement is supported by the NAPP, who summarised that “access to psychiatric treatment by telephone is best practice, facilitating genuine individualised mental health care and preventing traumatic or iatrogenic risks and harms that can result from in-person or video-telehealth access / attendance.”

The reinstatement of video supports will address some of the need in regional and rural Australia. Lived Experience Australia is urging the Australian Government to ensure best practice services – particularly telephone services – are available to all people seeking psychiatric care. 

Lived Experience Australia is a national mental health advocacy organisation, whose board, staff, and representatives all have lived experience as a mental health consumer, carer, or family member, or a combination of these. Our goal is to ensure that the voice of those who experience mental ill-health in any of these ways is heard and incorporated into policy reform to improve mental health services for all across Australia.