title: Policy initiative to improve access to psychological services for people with affective and anxiety disorders: population-level analysis.
abstract: BACKGROUND
  In 2006, Australia introduced new publicly funded psychological services for people with affective and anxiety disorders (the Better Access programme). Despite massive uptake, it has been suggested that Better Access is selectively treating socioeconomically advantaged people, including some who do not warrant treatment, and people already receiving equivalent services.
  
  
  OBJECTIVE
  To explore potential disparities in Better Access treatment using epidemiological data from the 2007 National Survey of Mental Health and Wellbeing.
  
  
  METHODS
  Logistic regression analyses examined patterns and correlates of service use in two populations: people who used the new psychological services in the previous 12 months; and people with any ICD-10 12-month affective and anxiety disorder, regardless of service use.
  
  
  RESULTS
  Most (93.2%) Better Access psychological services users had a 12-month ICD-10 mental disorder or another indicator of treatment need. Better Access users without affective or anxiety disorders were not more socioeconomically advantaged, and received less treatment than those with these disorders. Among the population with affective or anxiety disorders, non-service users were less likely to have a severe disorder and more likely to have anxiety disorder, without a comorbid affective disorder, than Better Access users. Better Access users comprised more new allied healthcare recipients than other service users. A substantial minority of non-service users (13.5%) had severe disorders, but most did not perceive a need for treatment.
  
  
  CONCLUSIONS
  Better Access does not appear to be overservicing individuals without potential need or contributing to social inequalities in mental healthcare. It appears to be reaching people who have not previously received psychological care. Treatment rates could be improved for some people with anxiety disorders.
authors.affiliation: Queensland Centre for Mental Health Research, Locked Bag 500, Sumner Park BC, Queensland 4077, Australia. harrism@qcmhr.uq.edu.au
authors.forename: Meredith G
authors.initials: MG
authors.lastname: Harris
authors.forename: Philip M
authors.initials: PM
authors.lastname: Burgess
authors.forename: Jane E
authors.initials: JE
authors.lastname: Pirkis
authors.forename: Tim N
authors.initials: TN
authors.lastname: Slade
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Whiteford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology / Q000628:therapy*; D001315:Australia / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006301:Health Services Needs and Demand; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000628:therapy*; D009313:National Health Programs; D015397:Program Evaluation; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D055815:Young Adult