The 2021-2022 Federal Budget

Another budget night has come and gone. In a dizzying display of hope on the night we are bombarded with unfathomable figures like a $503 billion investment into health care and phrases such as 'generational change' and 'landmark reforms' are bandied about freely. Then comes the hard work of separating hype from reality and distilling this into what this will actually equate to for members, clients and the mental health sector.

As someone much wiser than me once said, context is everything. So allow me to provide some context to this years budget.

The preceding 12 months have been tough, to put it mildly. We have been tested on many fronts but this pandemic has also placed health care and mental health front and centre. This budget was an opportunity for the government to put their money where their mouth is, so to speak.

I think it is important to point out, particularly to those who will be disappointed with the outcome, that the budget is not the only opportunity this year for what I believe are the necessary changes that need to occur in the mental health care system. This will (hopefully) come when the Select Committee into Mental Health and Suicide Prevention delivers their final report on 1 November 2021.

Without doubt, the government has invested significantly in the sector, but more needs to be done. This is why is it absolutely vital for psychologists to continue to come together and for AAPi to continue our strong advocacy campaigns.

Psychologists play a key role in prevention and early intervention so they need to remain affordable and accessible to everyone in the community. We also need to ensure psychologists remain in the workforce and do more to support students and provisional psychologists to reach full registration.

I want to sincerely thank you all for your support and hard work, whether you are a student or provisional psychologist just starting out in your career or those who have spent decades in the industry, you are the cornerstone of the mental health care system and AAPi will continue to do everything we can to support you.

Warmest Regards,

Tegan Carrison

Executive Director, AAPi

AAPi's Key Areas of Concern

Family and carer participation under Better Access: the budget included $111.4 million to support the take-up of group therapy sessions, and the participation of family and carers in treatment provided under Better Access. Unfortunately the 2 sessions available to family and carers will come out of a patients session allowance, leaving only 8 sessions annually for the individual. AAPi has been working hard to advocate for more support for family and carers under Medicare, however AAPi's recommendation was very clear that family and carer access should be in addition to individual sessions, not instead of. AAPi will be advocating very strongly to correct this.

Telehealth: The government has only funded telehealth for another six months. Telehealth must be made a permanent part of health care and is crucial to increasing access to the vital services psychologists provide.

Mental health hubs: The taxpayer cost of mental health hubs can be 400% greater than the cost of attending a private psychologist. New facilities will also take time to build/refurbish and recruit staff. We also have concerns that much of the money will be sent on infrastructure rather than service provision. Hubs are also only available to those in the immediate area and their continued operation is contingent on significant government investment. What happens to these communities when the government funding runs out? We would have preferred the government to invest further in Medicare and private practice. Our mental health workforce is already overwhelmed. More evidence is needed regarding their effectiveness for such a huge investment (close to $300 million). The hubs divert funding and the workforce away from small businesses (private practice psychology and allied health) whereas small business and private practices are typically embedded long term in a community. Properly investing in private practice through increasing the MBS rebates is a more immediate, cost-effective and long term solution.

Workforce growth, retention and acknowledgement: The mental health initiatives are mostly a reshuffling of an already stretched workforce, rather than increasing services and supporting our existing workforce through proper funding and acknowledging the vital role of all psychologists. The government needs to address why psychologists are leaving the profession, the barriers to attaining registration and mobilise the 5,500 provisional psychologists, which would immediately provide more psychologists in the community today. Ending the two tier system and increasing client rebates is vital and we will work with the government to achieve this.

Supporting rural allied health: While the investment in supporting rural GPs is welcome, the same investment is also required for allied health and psychology. Given the disparity in mental health for those in rural and remote communities and reduced access to services, surely supporting psychologists and allied health professionals requires urgent and immediate attention. Rural psychologists play an essential role in their communities and we need to do more to support them.

AAPi was pleased to see $14.2 million for new MBS items for allied health professionals who participate in case conferences which are organised by a patient's GP. This will support increased allied health participation in multidisciplinary, coordinated care for patients with chronic and complex conditions. We will provide more details on these item numbers when they become available.

We urgently need to improve the current processes in accessing a psychologist and reduce the red tape and administrative burden. AAPi looks forward to working with the Select Committee into Mental Health and Suicide Prevention to reform and transform our mental health system.

AAPi will continue to advocate for the raising of the Medicare rebate to $150 per session for the clients of all psychologists and implementing the Productivity Commission's recommendation to provide up to 40 rebated psychology sessions per year.

Budget Breakdown

For those who prefer a table format to summarise information, you can download a copy here.

Prevention and Early intervention

• Digital mental health service $111.2 million. Creation of a digital mental health service to provide low-cost or free, high-quality services and offer greater choice. This includes transforming the existing Head to Health gateway, the continued funding of existing digital mental health services and the implementation of the National Safety and Quality Digital Mental Health Standards.
• New/expectant parents $47.4 million. Expansion of services provided by Perinatal Anxiety and Depression Australia (PANDA), to provide digital perinatal screening, identify screening gaps and provide perinatal mental health screening nationally
• Alcohol & Drugs $74.1 million. Including funding to maintain AOD treatment services, including residential treatment services.
• Family Violence & mental health legal support $77.1 million. Funding to the National Legal Assistance Partnership to support the early resolution of legal issues for those experiencing mental illness or domestic violence.
• Employment $5.7million. Funding to support employment placements and work participation for those experiencing mental health.
• Aged Care 103.4 million. Funding for early referrals to Carer Gateway for assistance such as counselling by Aged Care Assessors to support informal carers.

Suicide prevention

• Delivery of aftercare services to every person following a suicide attempt after discharge from hospital and also trial the delivery of aftercare for those who may not have presented to hospital - $158.6 million.  
• Postvention services for bereaved or otherwise impacted by suicide - $22 million.
• The establishment of a National Suicide Prevention Office to oversee government’s suicide prevention approach - $12.8 million.
• National distress intervention trial established to trial direct support for those experiencing psychological distress - $31.2 million.
• Expansion of National Suicide Prevention Leadership & Support Program for funding of suicide prevention programs to whole of population - $61.6 million.
• Continued support for local suicide prevention program delivery - $12 million.

Treatment 

• Head to Help treatment centres establishing 8 new centres and continued funding of 8 existing centres. Establishing 24 new satellite centres. Establishing dedicated phone support service for intake, referrals and assessment - $487.2 million.
• Expansion of community-based adult mental health centres in partnership with State and Territory governments. Please note these are require State and Territory government support.
• New MBS funding for Repetitive Transcranial Magnetic Stimulation (rTMS) for medication-resistant depression for people who have tried two different classes of antidepressant medications yet are still unwell - $288.5 million
• Funding for participation of families and carers in the psychological treatment provided by the Better Access Scheme and for the uptake of group therapy services.  Family members and carers will be able to participate in two of a patient’s available Medicare subsided sessions per year if deemed clinically appropriate - $111.4 million.
• Support for people with a severe psychosocial disability to access mental health services where they are not funded by the NDIS - $171.3 million.
• Funding under new MBS items for allied health professionals to participate in GP organised case conferences for a mutual patient - $14.2 million.
• Youth Services $278.6 million. Continued funding and expansion of Headspace youth mental health centres: establishing 10 new centres and upgrading 5 satellite services.
• Child Services $54.2m to establish new centres for children 0-15years through Head to Health Kids services
• Eating Disorders $26.9 million for continued credentialing of workforce for the delivery of services under the eating disorder MBS items. Training staff in adult mental health centres. National Eating Disorder Research Centre to be established. Continued funding for ‘strive’ program by Eating Disorders Families Australia

Education

• Parent education and support programs to build parenting strategies and help parents identify and respond to problem behaviours - $42.3 million
• National guidelines to be created for inclusion of social/emotional wellbeing indicators in early childhood health checks - $0.5 million

Supporting the vulnerable 

• Complex Mental Health $11.1 million to improve outcomes and experiences of people with complex mental health needs (including autism and intellectual disability).
• Targeted interventions and initiatives to address high rates of suicide and mental health among Aboriginal and Torres Strait Islander peoples $79 million and Establishment of regional suicide prevention network investment $23.8 million.
• Mental health and early intervention funding for migrants and multicultural communities, including people who have experienced trauma and torture and to improve the cultural competence of workforce. - $16.9 million.
• Targeted mental health support and early intervention for fly-in, fly-out (FIFO) and drive-in, drive-out (DIDO) workers, $6.3 million.
• Support for small business owners to seek support for their mental health through the Ahead for Business digital hub, $0.9 million.
• New adult & child mental health centres will be established with a focus and expertise on mental health care for vulnerable groups, including Aboriginal & Torres Strait Islanders and LGBTIQ+.     

Strengthening the workforce & governance arrangements

• Increasing the size of the mental health workforce and upskilling staff, including increasing the number of nurses, psychologists and allied health practitioners $27.8 million. This is a promising addition and we look forward to more information.
• Boost allied health professionals in rural and remote communities through creation of additional 90 workplace training packages under the Allied Health Rural Health Generalist Pathway (AHRGP) program $9.6 million
• Funding to boost skills and identify opportunities for those who work with children and families $0.3 million.
• Funding to work with stakeholders in mental health to develop a national peak body for consumers to have greater say in the mental health system $0.3 million.
• Establish real time data monitoring and collection of mental health and suicide prevention systems to improve delivery of services to those in need $117.2 million.
• Boost to psychiatric workforce creating 30 additional training posts, strengthening rural pathways and promotion of psychiatry career pathway $11 million.
• Boost to mental health peer support workforce $3.1 million.
• Increase scholarships to Aboriginal & Torres Strait Islander peopleto increase their representation in the mental health workforce and to deliver care that is culturally safe $8.3 million.
• Funding for initiatives aimed at reducing the stigma of mental health in health practitioners and help promote mental health as a preferred career option $1 million.

Strengthening Primary Care

• Funding for the Primary Health Networks After Hours Program to increase after-hours access for people who may not have a regular GP, such as those who are homeless, residing in aged care, people with a disability, people with a mental illness, Aboriginal & Torres Strait Islander people and women and children $71.9 million.
• Extension of telehealth services until 31st December 2021 for GP, nursing, midwifery, allied health, allied mental health and specialist services $206.4 million.

Covid-19 Response

• Further investment in Beyond Blue’s Coronavirus Mental Wellbeing Support Service in addition to $10m previously funded to ensure program accessible to public through to 31st December 2021 $7.1 million.

Mental Health Research

• Mental health research funding to Deakin University for their Mental Health Australia General Clinical Trial Network (MAGNET) to develop new treatments, approaches to mental health, leadership, strategies and access $11.9 million
• Mental health research funding to the University of Sydney’s Growing Minds Australia program to develop and improve mental health treatments for children and youth $11.9 million.

Supporting Veterans and their families

The 2021-22 Budget will provide further support for veterans and their families, and includes:

• $16.9 million to extend the Provisional Access to Medical Treatmentprogram to ensure veterans can access treatment for 20 of the most common service-related conditions while their claim is being processed.
• $23.3 million to continue the Wellbeing and Support Program to provide mental health and wellbeing support to vulnerable veterans. This is in addition to 2020-21 Budget investments, including the establishment of the Joint Transition Authority to better assist with the transition to civilian life.

We will keep members updated with further information. We would love to hear your opinions on the budget. Please email [email protected] or join the AAPi Community Forum.