Cancer patients may be challenged to find enough mental health support after January 1 when the federal government halves the number of Medicare-subsidised mental health sessions.
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Breast Cancer Network Australia (BCNA) and the Psycho-oncology Co-operative Research Group (PoCoG) are two national cancer organisations which have condemned the cuts, that will reduce available subsidised sessions from 20 to 10.
PoCoG chair professor Brian Kelly said there were effective psychological interventions for cancer patients with depression and anxiety associated with their illness, but access to care was limited.
"The mental health needs of those with a cancer diagnosis are specific and often acute, including support to deal with fear of recurrence or progression, body image issues, pain management, and fear of death and dying," he said.
Medicare-subsidised sessions were increased from 10 to 20 under the former federal government in October 2020 as a response to the growing mental health needs of Australians in the COVID-19 pandemic.
According to the Australian Institute of Health and Welfare (AIHW) 11 per cent of Australians - 2.9 million people - accessed 14 million Medicare-subsidised mental health services in 2020 to 2021 period.
And demand for mental health services across the broader community remains higher than pre-pandemic levels.
The latest data from the AIHW showed in the four weeks to September 4, 2022, about 1.1 million subsidised mental health-related services were processed nationally, up 11 per cent from the same period in 2019.
For the same period, calls to Lifeline increased by 19 per cent from 2019 at about 84,200 calls, and contacts made to Beyond Blue, at about 25,500, jumped 26 per cent from 2019.
An independent report by the University of Melbourne evaluating the scheme, released this month, recommended 'the additional 10 sessions continue to be made available and should be targeted towards those with complex mental health needs'.
BCNA director policy, advocacy and support services Vicki Durston said her group, with PoCoG, was calling for the federal government to heed the evaluation's advice and maintain the extra 10 sessions.
"We feel that the mental health needs of those with complex comorbidities such as cancer are not being considered in this policy change by government," she said.
"We know those with cancer have increased need for mental health support, with around 40 per cent experiencing clinically significant mental health issues. Many people with cancer require much more than just 10 psychologist appointments per year."
A 2017 BCNA survey found four out of five respondents reported not all their emotional wellbeing needs were being met, including needing help with self esteem, help to cope with shock after diagnosis, information on coping during treatment, being referred to counsellors, and encouragement to seek support.
Ms Durston said there needed to be a long-term solution that increased access to subsidised support and was fit-for-purpose for Australians with cancer.
"The financial burden of privately funding additional appointments is a barrier and will significantly impact on equity of access to psychological support for all Australians with cancer," she said.
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Speaking to ACM, federal health minister Mark Butler said the University of Melbourne evaluation was not conclusive around how the additional 10 sessions could be targeted.
"It noted a nuanced and stepped approached was needed, for this reason we're promptly convening a forum [in early 2023] to assess reform options with the sector," he said.
"Many [subsidised] providers are currently at capacity, limiting access to supply.
"The Australian Government is committed to expanding the range and supply of psychological services for everyone, but this ultimately will involve building the mental health workforce and developing new digital and direct models of service."
In the October 2022 federal budget, the government provided an additional $114 million for mental health services including $47.7 million to restore Medicare-subsidised online psychiatry consultations for rural and regional patients.
Mr Butler said the government recognised the "complexity and fragmentation" of the mental health system, and would meet with a forum of experts and people with lived experience of mental illness for advice on how to improve the subsidies scheme.
"The evaluation reinforces the importance, going forward, of making sure that there is more equitable access to this important program," he said.
"The Government's goal is to develop and implement a more equitable and sustainable Better Access program and broader mental health system - one based on the evidence - and that ensures no one is left behind."
