{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:50:42Z","timestamp":1792695042530,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003921","name":"Department of Health, Disability and Ageing","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Australia\u2019s Better Access initiative enables Australians with mental disorders to receive sessions of evidence-based psychological treatment following referral from an eligible provider (usually a general practitioner), subsidised through Medicare. As part of a commissioned evaluation, we examined patterns of Better Access treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We sourced aggregated Medicare Benefits Schedule data from Services Australia on Better Access services delivered from 1 January 2018 to 30 June 2022. From this, we developed profiles of Better Access treatment over time and according to key consumer characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In 2021, over 1.3 million Australians received at least one treatment session subsidised through Better Access (up by 0.9% per year since 2018). People living in medium\/high socioeconomic status areas within major cities, females and young adults were more likely to receive Better Access treatment compared to other groups. Consumers made an out-of-pocket payment for two-thirds (64.8%) of treatment sessions in 2021 (vs 52.7% in 2018). The median out-of-pocket payment per session was constant between 2018 and 2021 ($74) but increased to $90 in the first half of 2022. In 2021, 29.9% of fees charged for all treatment sessions nationally came from consumer out-of-pocket payments (vs 24.5% in 2018). Fewer people accessed treatment following referral in 2021 than in 2018 (58.8% vs 66.9%), and those who did waited longer until their first session (median 22\u2009days in 2021 vs 18\u2009days in 2018).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Better Access enables many Australians to receive psychological treatment. Efforts are required to address gaps in access and increased wait time and consumer costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00048674251409006","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:21:58Z","timestamp":1768782118000},"page":"11-24","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Uptake, utilisation and costs of treatment through Better Access from 2018 to 2022: An analysis of Medicare Benefits Schedule data"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2731-7345","authenticated-orcid":false,"given":"Caley","family":"Tapp","sequence":"first","affiliation":[{"name":"School of Public Health, The University of Queensland, Brisbane, QLD, Australia"},{"name":"Queensland Centre for Mental Health Research, Brisbane, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2482-7953","authenticated-orcid":false,"given":"Roman","family":"Scheurer","sequence":"additional","affiliation":[{"name":"School of Public Health, The University of Queensland, Brisbane, QLD, Australia"},{"name":"Queensland Centre for Mental Health Research, Brisbane, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7184-0363","authenticated-orcid":false,"given":"Philip","family":"Burgess","sequence":"additional","affiliation":[{"name":"School of Public Health, The University of Queensland, Brisbane, QLD, Australia"},{"name":"Queensland Centre for Mental Health Research, Brisbane, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9442-6824","authenticated-orcid":false,"given":"Long Khanh-Dao","family":"Le","sequence":"additional","affiliation":[{"name":"Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7127-9462","authenticated-orcid":false,"given":"Cathrine","family":"Mihalopoulos","sequence":"additional","affiliation":[{"name":"Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6614-271X","authenticated-orcid":false,"given":"Dianne","family":"Currier","sequence":"additional","affiliation":[{"name":"Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2538-4472","authenticated-orcid":false,"given":"Jane","family":"Pirkis","sequence":"additional","affiliation":[{"name":"Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-729X","authenticated-orcid":false,"given":"Meredith","family":"Harris","sequence":"additional","affiliation":[{"name":"School of Public Health, The University of Queensland, Brisbane, QLD, Australia"},{"name":"Queensland Centre for Mental Health Research, Brisbane, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,18]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251409017"},{"key":"e_1_3_3_3_1","unstructured":"Australian Bureau of Statistics (ABS) (2018a) 1270.0.55.005 \u2013 Australian Statistical Geography Standard (ASGS): Volume 5 \u2013 Remoteness Structure July 2016. Available at: https:\/\/www.abs.gov.au\/ausstats\/abs%40.nsf\/mf\/1270.0.55.005 (accessed 11 August 2022)."},{"key":"e_1_3_3_4_1","unstructured":"Australian Bureau of Statistics (ABS) (2018b) Census of Population and Housing: Socio-economic Indexes for Areas (SEIFA) Australia 2016 (Cat. No. 2033.0.55.001). Available at: https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/mf\/2033.0.55.001 (accessed 11 August 2022)."},{"key":"e_1_3_3_5_1","unstructured":"Australian Bureau of Statistics (ABS) (2018c) National Health Survey: First Results 2017\u201318 \u2013 Australia. Table 7 Psychological Distress \u2013 Australia. Available at: https:\/\/www.abs.gov.au\/statistics\/health\/health-conditions-and-risks\/national-health-survey\/2017-18#data-downloads (accessed 10 June 2024)."},{"key":"e_1_3_3_6_1","unstructured":"Australian Bureau of Statistics (ABS) (2022a) Australian Bureau of Statistics. Consumer Price Index Australia. TABLE 7. CPI: Group Sub-group and Expenditure Class Weighted Average of Eight Capital Cities. 2022. Available at: https:\/\/www.abs.gov.au\/statistics\/economy\/price-indexes-and-inflation\/consumer-price-index-australia\/jun-2022\/640105.xlsx (accessed 11 August 2022)."},{"key":"e_1_3_3_7_1","unstructured":"Australian Bureau of Statistics (ABS) (2022b) National Health Survey 2022 -Australia. Table 12 Psychological Distress by Age and Sex. Available at: https:\/\/www.abs.gov.au\/statistics\/health\/health-conditions-and-risks\/national-health-survey\/2022 (accessed 10 June 2024)."},{"key":"e_1_3_3_8_1","unstructured":"Australian Government Department of Health and Aged Care (DHAC) (2022) National Mental Health Workforce Strategy Taskforce. Available at: https:\/\/www.health.gov.au\/committees-and-groups\/national-mental-health-workforce-strategy-taskforce (accessed 4 November 2022)."},{"key":"e_1_3_3_9_1","unstructured":"Australian Government Department of Health and Aged Care (DHAC) (2023) Better Access Initiative. Available at: https:\/\/www.health.gov.au\/initiatives-and-programs\/better-access-initiative#about-the-better-access-initiative (accessed 3 April 2023)."},{"key":"e_1_3_3_10_1","unstructured":"Australian Government Department of Health Disability and Ageing (2025) Better Access Changes from 1 November 2025. Available at: https:\/\/www.mbsonline.gov.au\/internet\/mbsonline\/publishing.nsf\/Content\/Factsheet-Better+Access+changes+from+1+November+2025 (accessed 13 November 2025)."},{"key":"e_1_3_3_11_1","unstructured":"Australian Institute of Health and Welfare (AIHW) (2021) Medicare-subsidised GP Allied Health and Specialist Health Care across Local Areas: 2019\u201320 To 2020\u201321. Available at: https:\/\/www.aihw.gov.au\/reports\/primary-health-care\/medicare-subsidised-health-local-areas-2020-21\/contents\/about (accessed 12 September 2022)."},{"key":"e_1_3_3_12_1","unstructured":"Australian Institute of Health and Welfare (AIHW) (n.d.) Technical Notes. Available at: https:\/\/www.aihw.gov.au\/getmedia\/28a8eda7-795d-48b2-896c-709f06b9490a\/technical-notes.pdf.aspx (accessed 23 November 2022)."},{"key":"e_1_3_3_13_1","unstructured":"Australian Medical Association (2022) Why Medicare Indexation Matters. Available at: https:\/\/www.ama.com.au\/articles\/why-medicare-indexation-matters (accessed 30 June 2023)."},{"key":"e_1_3_3_14_1","unstructured":"Australian Psychological Society (2022) 1 In 3 Psychologists Are Unable to See New Clients but Australians Need Help More Than Ever. Available at: https:\/\/psychology.org.au\/for-members\/news-and-updates\/news\/2022\/australians-need-psychological-help-more-than-ever (accessed 4 December 2022)."},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251404787"},{"key":"e_1_3_3_16_1","unstructured":"Chrysanthos N (2023) Psychologists Raise Alarm Six Months after Medicare Sessions Were Slashed. Available at: https:\/\/www.smh.com.au\/politics\/federal\/psychologists-raise-alarm-six-months-after-medicare-sessions-were-slashed-20230721-p5dq54.html (accessed 25 May 2024)."},{"key":"e_1_3_3_17_1","unstructured":"Commonwealth of Australia (2023) Budget Paper No. 2 Budget Measures 2023\u201324. Available at: https:\/\/budget.gov.au\/content\/bp2\/index.htm (accessed 19 July 2023)."},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251404786"},{"key":"e_1_3_3_19_1","unstructured":"Duckett S Stobart A Lin L (2022) Not So Universal: How to Reduce Out-of-pocket Healthcare Payments. Available at: https:\/\/grattan.edu.au\/wp-content\/uploads\/2022\/03\/Not-so-universal-how-to-reduce-out-of-pocket-healthcare-payments-Grattan-Report.pdf (accessed 8 May 2022)."},{"key":"e_1_3_3_20_1","author":"Harris M","year":"2010","unstructured":"Harris M, Pirkis J, Burgess P, et al. (2010) Evaluation of the Better Access to Psychiatrists, Psychologists and GPs through the Medicare Benefits Schedule Initiative: Component B \u2013 an Analysis of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Schedule (PBS) Administrative Data: Report to Steering Committee.","journal-title":"Evaluation of the Better Access to Psychiatrists, Psychologists and GPs through the Medicare Benefits Schedule Initiative: Component B \u2013 an Analysis of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Schedule (PBS) Administrative Data: Report to Steering Committee"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251406028"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja12.10555"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00330"},{"key":"e_1_3_3_24_1","unstructured":"Minister for Health and Aged Care (2022) Improving Better Access for All Australians. Available at: https:\/\/www.health.gov.au\/ministers\/the-hon-mark-butler-mp\/media\/improving-better-access-for-all-australians (accessed 29 May 2024)"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251404766"},{"key":"e_1_3_3_26_1","unstructured":"Orr A (2022) \u2018They Saved My Life\u2019: Cut to Medicare-funded Psychology Sessions Raises Mental Health Concerns. Available at: https:\/\/www.sbs.com.au\/news\/article\/they-saved-my-life-cut-to-medicare-funded-psychology-sessions-raises-mental-health-concerns\/zv645yt1y (accessed 17 May 2024)."},{"key":"e_1_3_3_27_1","unstructured":"Pirkis J Currier D Harris M et al. (2022) Evaluation of the Better Access initiative \u2013 Final report. Available at: https:\/\/www.health.gov.au\/resources\/collections\/evaluation-of-the-better-access-initiative-final-report (accessed 5 September 2023)."},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251405142"},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251405081"},{"key":"e_1_3_3_30_1","unstructured":"Productivity Commission (2020) Mental Health Report No. 95. Available at: https:\/\/www.pc.gov.au\/inquiries\/completed\/mental-health\/report\/mental-health.pdf (accessed 2 May 2023)."},{"key":"e_1_3_3_31_1","unstructured":"Rosenberg S Hickie I (2022) Access to Primary Mental Health Care Remains Critical. Available at: https:\/\/insightplus.mja.com.au\/2022\/28\/access-to-primary-mental-health-care-remains-critical\/ (accessed 27 May 2024)."},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH22154"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50068"},{"key":"e_1_3_3_34_1","volume-title":"A Road Map for Tackling Out-of-pocket Health Care Costs","author":"Russell L","year":"2019","unstructured":"Russell L, Doggett J (2019) A Road Map for Tackling Out-of-pocket Health Care Costs. Melbourne, VIC, Australia: Analysis and Policy Observatory."},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251406056"}],"container-title":["Australian &amp; New Zealand Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00048674251409006","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00048674251409006","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00048674251409006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:58:26Z","timestamp":1777373906000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00048674251409006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,18]]},"references-count":34,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/00048674251409006"],"URL":"https:\/\/doi.org\/10.1177\/00048674251409006","relation":{},"ISSN":["0004-8674","1440-1614"],"issn-type":[{"value":"0004-8674","type":"print"},{"value":"1440-1614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,18]]}}}