Mental health care has been a hot topic of discussion in Australia for some time. Data shows that about 14% of issues dealt with in the Australian health care system are related to mental health but only around 7% of the health budget is dedicated to this sector. Historically, spending in mental health in Australia has been less than in other OECD countries.
Around $8.5bn is spent each year on mental health services in Australia including residential and community services, hospital based services, and consultation with specialists and General Practitioners.
Some mental health programs have recently been wound down to fund the National Disability Insurance Scheme (NDIS). Around 230,000 Australians are estimated to have ongoing severe mental illness but the majority will have conditions which do not meet the criteria for accessing the NDIS.
In the Australian health care system state and territory governments have primary responsibility for funding psychosocial disability, that is people who experience impairments and restricted participation due to mental health conditions, but the government acknowledges more support is needed. The 2017-18 Federal budget allocated $173m to be invested in mental health including $80m over four years to fund psychosocial support services for people with severe mental illness who are not eligible for the NDIS.
The system for accessing mental health care typically begins with a GP. Referrals to psychiatrists and psychologists can have lengthy waiting lists due to skilled workforce shortages in this area. Consequently Australia continues to rely heavily on international medical graduates to meet job demands in mental health, particularly in rural and regional areas. In the interim the government has allocated $9.1m to improve telehealth for psychosocial services in regional areas. In addition to new budget measures the government is undertaking research into the number and location of student medical places to determine whether a redistribution of medical school places will assist with meeting skilled workforce shortages.
In a submission to the Minister for Education and Training regarding proposals to changes to the Skilled Occupation List for 2016-17, the Royal Australian and New Zealand College of Psychiatrists stated that the current skilled workforce shortage faced by psychiatry is likely to worsen over time. The College emphasised a need to retain the overseas trained psychiatrists already working in Australia and for the government to carefully consider policies that could impact on the capacity for overseas trained psychiatrists to work in the Australian health care system.
The role of Psychiatrist appears on the new Medium and Long-term Strategic Skills List (MLTSSL) approved for use under Australia’s permanent and temporary skilled workforce visa programmes as job demand for roles in mental health continue.