title: Australia's Better Access initiative: an evaluation.
abstract: BACKGROUND
  Australia's Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) initiative involves a series of Medicare Benefits Schedule (MBS) item numbers which offer a rebate for selected services delivered by eligible clinicians. There has been considerable debate about the appropriateness and effectiveness of Better Access, much of which has been based on limited evidence. The current paper contributes to this debate by presenting the findings of a study which profiled the clinical and treatment characteristics of Better Access patients and examined the outcomes of their care.
  
  
  METHODS
  We approached a stratified random sample of providers who had billed for at least 100 occasions of service under the Better Access item numbers in 2008 (509 clinical psychologists, 640 registered psychologists, 1280 GPs) and invited them to participate. Those who agreed were asked to recruit 5-10 Better Access patients according to a specific protocol. We collected data that enabled us to profile providers, patients and sessions. We also collected pre- and post-treatment patient outcome data, using the Kessler-10 (K-10) and the Depression Anxiety Stress Scales (DASS-21).
  
  
  RESULTS
  In total, 883 patients were recruited into the study (289 by 41 clinical psychologists, 317 by 49 registered psychologists and 277 by 39 GPs). More than 90% of participating patients had diagnoses of depression and/or anxiety (compared with 13% of the general population). More than 80% were experiencing high or very high levels of psychological distress (compared with 10% of the general population). Around half of all participating patients had no previous history of mental health care. Patients experienced statistically significant improvements in average K-10 and DASS-21 scores from pre- to post-treatment.
  
  
  CONCLUSIONS
  The findings suggest that Better Access is playing an important part in meeting the community's previously unmet need for mental health care.
authors: Centre for Health Policy, Programs and Economics, Melbourne School of Population Health, The University of Melbourne, Melbourne, Victoria 3010, Australia. j.pirkis@unimelb.edu.au
authors: Jane
authors: J
authors: Pirkis
authors: Maria
authors: M
authors: Ftanou
authors: Michelle
authors: M
authors: Williamson
authors: Anna
authors: A
authors: Machlin
authors: Matthew J
authors: MJ
authors: Spittal
authors: Bridget
authors: B
authors: Bassilios
authors: Meredith
authors: M
authors: Harris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D008605:Mental Health Services; D008875:Middle Aged; D011785:Quality Assurance, Health Care