What impact will new Medicare telehealth therapy have?

The Federal Government has launched a free therapy service, available without a GP referral, to help ‘emerging mental illness or temporary distress’ – but one GP has warned the way it fits into existing services could be ‘problematic’.
 
The new low-intensity cognitive behavioural therapy (LiCBT) is being funded by the Government and run by St Vincent’s Health Australia, with access via the new Medicare Mental Health Check-In website, launched in January.
 
As announced on Wednesday, anyone aged 16 years or older ‘who has, or is at risk of, emerging mental illness or temporary distress’ is eligible for the service ‘if LiCBT is suitable for their needs’.
 
Federal Health and Aged Care Minister Mark Butler called it ‘a major milestone’ in the reform of mental health services, saying the type of service has been recommended by inquiries and experts ‘for years’.
 
‘By helping people with mild or temporary challenges, it will head off more serious challenges and free up capacity in the mental health system for those with deep-seated challenges,’ he said.
 
However, Sydney GP and Chair of RACGP Specific Interests Psychological Medicine Dr Karen Spielman expressed concerns about how the service will integrate into the existing system, as well as the possibility that at-risk patients could slip through the gaps.
 
‘I know that the Government is trying hard to address the mental health crisis – there’s a huge mental health crisis – and good on them for trying,’ she told newsGP.  
 
‘There’s this, and there’s the Medicare Mental Health centres, but from our point of view, we have the skills. We’re in the community.
 
‘Please just fix our rebates, have better support for GPs who are already doing it.
 
‘In the long run, you’re going to be providing more bespoke services to people in the community, with better oversight.’
 
Minister Butler estimates around 150,000 people a year will use the service.
 
‘This is really designed for people who are dealing with temporary distress, more mild to moderate levels of distress, and worry that doesn’t need full-blown psychological therapy but just needs some advice and support for people to get back on the track,’ he told the ABC.  
 
However, while Dr Spielman agreed early intervention is ‘always the best thing’, she has many questions about how it will work.
 
‘Hiving this off into a telehealth platform, I don’t think that’s the answer for early intervention,’ she said.  
 
‘How do they feed back to GPs? It’s problematic.
 
‘They’re going to be getting people who haven’t been able to access services, who may not be appropriate for the service.
 
‘It needs to be linked back in with skilled practitioners, including GPs, with a system in place that includes communication, collaboration and the opportunity to step care up and down as needed, and make sure that people aren’t falling through the cracks and experiencing harm.’
 
In November, the Government announced that St Vincent’s Health Australia would operate the digital mental health service to be known as Medicare Mental Health Check In, with $588.5 million set aside over eight years from 2024–25.
 
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