«The evidence is strong that there is an economic pay-off for early intervention of this kind,» Professor Fels said.
While the review’s proposal for the new Medicare item number has not been costed, it would likely add to the $9 billion a year of taxpayer funds spent on mental health.
The latest data from the Australian Institute of Health and Welfare shows that while one in five Australians experienced a mental disorder over 12 months, less than half received Medicare-subsidised treatment.
Professor Fels said allowing people to access therapy before developing a full-blown disorder could help «nip mental illness in the bud» and would ultimately result in cost savings.
«It also encourages access to treatment, particularly by those who don’t otherwise come forward, for fear of records being kept and unfairly being used against them in seeking jobs,» Professor Fels said.
«There is often limited alternative access to treatment because a majority of public services are for severely mentally ill people.»
Psychiatrist and former Australian of the Year Patrick McGorry questioned the need for the new item number, saying access to Medicare rebates was already provided on the basis of a patient’s «need for care».
He warned against any approach that could give patients the idea that a diagnosis would be stigmatised, and said there was «no evidence» of reluctance to get a GP-issued mental health plan.
«Every second person is disclosing that they’ve got depression,» he said.
Professor McGorry said the existence of lengthy waiting lists for psychologists was evidence that people were willing to seek help — but that more services were needed.
He welcomed a separate recommendation in the report that the number of therapy sessions that can be accessed by patients with moderate to severe mental illness be increased beyond the current 10-session annual limit, with the potential for up to 70 sessions in the most severe cases.
«There shouldn’t be a cap; you don’t cap the number of chemotherapy sessions based on cost,» Professor McGorry said.
Professor Fels said the proposed new item number for «at risk» patients would also be useful for the prevention of relapse among those who had recovered.
Ian Hickie from Sydney University’s Brain and Mind Centre said any changes to mental health rebates should extend coverage to «bundled care» provided by groups of practitioners.
Without this, he said, «you’ll get more access, but you won’t see better outcomes».
The Medicare review, launched by the federal government in 2015, is examining more than 5700 Medicare Benefits Schedule item numbers across the health system.
The Mental Health Reference Group’s report says research shows that 10 sessions is not enough to improve clinical outcomes in cases of moderate to severe mental illness.
Psychologists have reported that some mentally ill patients use up their 10 sessions within a period of months, then stop therapy for the rest of the year, only to return the following year needing further treatment.
The report noted the mental health reference group had been unable to agree on the details of a new three-tiered model of care, with disagreement over whether to give higher rebates to clinical psychologists and limit work for non-clinical registered psychologists to less severe cases.
A spokeswoman for Health Minister Greg Hunt said the report was out for consultation until May 17, and that the MBS Review taskforce would will consider feedback before making any final recommendations to the government.
Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.