Could negative outcomes of psychotherapies be contributing to the lack of an overall population effect from the Australian Better Access initiative?. (June 2023)

• Record Type: Journal Article
• Authors: Allison, Stephen; Looi, Jeffrey CL; Kisely, Steve; Bastiampillai, Tarun
• Is Part Of: Australasian psychiatry. Volume 31:Number 3(2023)
• Page Start: 339
• Page End: 342
• Publication Date: 2023-06
• Subjects: Psychotherapies -- negative effects -- Australian Medicare Better Access initiative; Psychiatry -- Australasia -- Periodicals; Psychiatry -- Periodicals; 616.89005
• DOI: 10.1177/10398562231172417
• Languages: English
• ISSNs: 1039-8562

Abstract

Objective: We examine deterioration in psychotherapies, as reported in the recent evaluation of the Australian Medicare Better Access initiative. Conclusion: A focus on patients who experience poor clinical outcomes helps programs minimise harm and improve quality of care. The Better Access evaluation found the mental health of 20–40% of patients deteriorated. This may partly explain why population distress and suicide rates were not reduced by the introduction of the Better Access initiative. Deterioration was more likely for milder conditions, and less likely for severe conditions, which also improved the most. Using severity as a criterion for priority setting and resource allocation may minimise patient risk and maximise benefits. Patients with severe conditions may require considerably more sessions than the current average for Better Access psychotherapies.