{"id":936109,"date":"2026-10-21T21:08:09","date_gmt":"2026-10-21T21:08:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/936109\/"},"modified":"2026-10-21T21:08:09","modified_gmt":"2026-10-21T21:08:09","slug":"seeing-a-psychologist-is-becoming-more-unequal-and-our-map-shows-the-gap","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/936109\/","title":{"rendered":"Seeing a psychologist is becoming more unequal \u2013 and our map shows the gap"},"content":{"rendered":"

When you\u2019re struggling with your mental health, visiting your GP for a mental health treatment plan<\/a> can be an important first step.<\/p>\n

These plans indicate a diagnosed mental health condition (such as depression or anxiety) and allow you to access up to ten subsidised psychotherapy (or \u201ctalk therapy\u201d) sessions through Medicare\u2019s Better Access Initiative<\/a>. <\/p>\n

But what happens next? <\/p>\n

Our recently published research<\/a> suggests whether you actually see a psychologist may depend on where you live.<\/p>\n

We found those living in low-income neighourhoods were much less likely to receive psychological care soon after receiving a plan, compared to those in wealthier neighbourhoods.<\/p>\n

And in the decade between 2014\u201323, this gap widened substantially \u2013 particularly for children.<\/p>\n

Even with subsidies, mental health care can be expensive<\/p>\n

While private psychologists can choose their own rate, the suggested fee<\/a> for a 45\u201360 minute consultation is A$330. But the Medicare rebate<\/a> is set at $149.05 for a clinical psychologist \u2013 and even less<\/a> for general psychologists \u2013 meaning the gap you pay can be substantial.<\/p>\n

Read more:
\n Need to see a psychologist? How to find one that\u2019s right for you<\/a><\/p>\n

High out-of-pocket costs<\/a>, long waits<\/a> and limited local services<\/a> can prevent people from getting the care they need.<\/p>\n

In the Australian Bureau of Statistics\u2019 2024\u201325 Patient Experience Survey<\/a>, about one in four people who needed to see a psychologist reported delaying or going without care because of the cost.<\/p>\n

Financial barriers to mental health care were more common in disadvantaged areas<\/a>.<\/p>\n

What we did and what we found<\/p>\n

We wanted to understand how large the income-related gaps in psychological care are across Australia.<\/p>\n

We used de-identified tax and Medicare data to study 5.4 million Australians who received a GP mental health treatment plan between 2014 and 2023, to look at whether they went on to receive Medicare-subsidised psychotherapy (talk therapy) within three months.<\/p>\n

This included services delivered by eligible psychologists, social workers and occupational therapists.<\/p>\n

In one study<\/a> of adults, we found substantial regional differences in access: in 2023, psychotherapy use within three months of receiving a GP mental health treatment plan ranged from approximately 28% in parts of regional New South Wales and South Australia to 60% in inner Perth. <\/p>\n<\/p>\n

But we also wanted to look at whether income-related gaps had changed over time, and whether children are affected differently from adults. <\/p>\n

In another, related study<\/a>, we looked separately at children under 18 and adults aged 25\u201354, and compared neighbourhoods with different average incomes.<\/p>\n

In 2023, only 32% of children in the lowest-income neighbourhoods received psychotherapy within three months of receiving their plan, compared with 55% in the highest-income neighbourhoods. For adults, the figures were 40% versus 55%.<\/p>\n

The gap has widened<\/p>\n

A decade earlier, rates of psychotherapy use were higher across the country and the income-related gaps were smaller. <\/p>\n

In 2014, 56% of children and 53% of adults in the lowest-income neighbourhoods received psychotherapy within three months of getting a plan. This compared to 70% of children and 61% of adults in the highest-income neighbourhoods. <\/p>\n

Over the following decade, uptake fell across all groups \u2013 but more steeply in low-income neighbourhoods. <\/p>\n

As a result, the income gap widened, especially for children. The divide grew particularly sharply during the COVID pandemic. <\/p>\n

Among children in the lowest-income neighbourhoods, the proportion receiving timely psychotherapy fell from more than half (56%) in 2014 to around one-third (32%) in 2023. <\/p>\n

We also find a growing \u201creverse\u201d pattern for medication. Lower-income people are increasingly likely to receive antidepressants without psychotherapy, suggesting a shift toward lower-cost treatment pathways.<\/p>\n

This is concerning, especially for children, for whom psychiatric medication without psychotherapy is not typically recommended<\/a>.<\/p>\n

What\u2019s behind this widening gap?<\/p>\n

We checked whether the widening income gap could be explained by an increase in diagnoses of complex conditions, such as ADHD<\/a> and autism<\/a>, or by the rapid expansion of telehealth<\/a> in 2020. <\/p>\n

But when we analysed these factors separately, the income gap remained \u2013 whether or not people had also seen a psychiatrist or paediatrician for a complex condition, and whether they\u2019d received psychotherapy via telehealth or face-to-face.<\/p>\n

Rising costs are a more plausible explanation. Between 2014 and 2023, the average out-of-pocket cost of a first therapy session rose<\/a> from about $44 to $90 for children, and from $35 to $80 for adults. These amounts are adjusted for inflation and expressed in 2023 dollars.<\/p>\n

The price increases are consistent with demand for mental health care growing faster than providers\u2019 capacity to offer appointments<\/a>, particularly during the COVID pandemic. <\/p>\n

When demand outpaces supply, waiting times can lengthen and fees can rise. People on lower incomes have less capacity to absorb these higher costs.<\/p>\n

Expanding capacity takes time. Training new psychologists takes years, while shifting psychologists from other sectors may create shortages elsewhere. <\/p>\n

Read more:
\n Australia has an ongoing GP shortage. Why can\u2019t we just train more GPs?<\/a><\/p>\n

The regional differences we observed<\/a> also point to uneven access: where psychologists work matters, as well as how many there are.<\/p>\n

So, what would actually help?<\/p>\n

Reducing out-of-pocket costs should be a priority. This could include increasing Medicare rebates, introducing targeted subsidies for low-income families, or expanding low-fee and no-gap service models. <\/p>\n

Bulk billing may also have a role. Recent reforms have strengthened incentives for GPs to bulk bill<\/a>, particularly in regional and rural areas. A similar approach could be considered for psychological services, though we need to first carefully evaluate whether these GP reforms have worked. <\/p>\n

Improving access will also require building a bigger workforce<\/a>. Expanding training places, addressing bottlenecks in supervised placements, and supporting early-career psychologists could help increase capacity while maintaining high standards of training and clinical care.<\/p>\n

In rural and regional areas, this could mean targeted programs to attract and retain psychologists where shortages are greatest. These could include extra funding for providers<\/a> in those areas, relocation payments<\/a>, or waiving<\/a> higher education loans.<\/p>\n

For people with milder symptoms, lower-intensity options<\/a> such as guided digital therapy<\/a> or suitable group programs may help reduce pressure on individual therapy services.<\/p>\n

Read more:
\n How does Medicare\u2019s new Mental Health Check In work? Is this low-intensity CBT likely to help?<\/a><\/p>\n

Ultimately, Medicare-subsidised psychotherapy was designed to make mental health care more accessible. Our findings show access has declined and become less equal.<\/p>\n

Reforms should prioritise reversing this decline for people in low-income neighbourhoods, especially children.<\/p>\n","protected":false},"excerpt":{"rendered":"When you\u2019re struggling with your mental health, visiting your GP for a mental health treatment plan can be…\n","protected":false},"author":2,"featured_media":936110,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[64,63,137,514,515],"class_list":["post-936109","post","type-post","status-publish","format-standard","has-post-thumbnail","category-mental-health","tag-au","tag-australia","tag-health","tag-mental-health","tag-mentalhealth"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/936109","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=936109"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/936109\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/936110"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=936109"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=936109"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=936109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}