Women’s uptake of Medicare Benefits Schedule mental health items for general practitioners, psychologists and other allied mental health professionals

Julie E Byles, Xenia Dolja-Gore, Deborah J Loxton, Lynne Parkinson and Jennifer A Stewart Williams
Med J Aust 2011; 194 (4): 175-179.


Objective: To quantify women’s uptake of Medicare Benefits Schedule mental health items, compare characteristics of women by mental health service use, and investigate the impact on Medicare costs.

Design, setting and participants: Analysis of linked survey data and Medicare records (November 2006 – December 2007) of 14 911 consenting participants of the Australian Longitudinal Study on Women’s Health (ALSWH) across three birth cohorts (1921–1926 [“older cohort”], 1946–1951 [“mid-age cohort”], and 1973–1978 [“younger cohort”]).

Main outcome measures: Uptake of mental health items; 36-Item Short Form Health Survey (SF-36) Mental Health Index scores from ALSWH surveys; and patient (out-of-pocket) and benefit (government) costs from Medicare data.

Results: A large proportion of women who reported mental health problems made no mental health claims (on the most recent survey, 88%, 90% and 99% of the younger, mid-age and older cohorts, respectively). Socioeconomically disadvantaged women were less likely to use the services. SF-36 Mental Health Index scores among women in the younger and mid-age cohorts were lowest for women who had accessed mental health items or self-reported a recent mental health condition. Mental health items are associated with higher costs to women and government.

Conclusion: Although there has been rapid uptake of mental health items, uptake by women with mental health needs is low and there is potential socioeconomic inequity.

  • Julie E Byles1
  • Xenia Dolja-Gore2
  • Deborah J Loxton3
  • Lynne Parkinson4
  • Jennifer A Stewart Williams5

  • Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW.


The ALSWH was funded by the Australian Government Department of Health and Ageing. This study was supported by a grant from Australian Rotary Health.

Competing interests:

None identified.

  • 1. Lucht M, Schaub RT, Meyer C, et al. Gender differences in unipolar depression: a general population survey of adults between age 18 to 64 of German nationality. J Affect Disord 2003; 77: 203-211.
  • 2. Hyde JS, Mezulis AH, Abramson LY. The ABCs of depression: integrating affective, biological and cognitive models to explain the emergence of the gender difference in depression. Psychol Rev 2008; 115: 291-313.
  • 3. Abbass A, Hancock J, Henderson J, Kisely S. Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database Syst Rev 2006; (4): CD004687.
  • 4. Chisholm D, Sanderson K, Ayuso-Mateos JL, et al. Reducing the global burden of depression: population-level analysis of intervention cost-effectiveness in 14 world regions. Br J Psychiatry 2004; 184: 393-403.
  • 5. Hickey I, McGorry P. Increased access to evidence-based primary mental health care: will the implementation match the rhetoric? Med J Aust 2007; 187: 69-71. <MJA full text>
  • 6. Crosbie D, Rosenberg S. Mental health and the new Medicare services: an analysis of the first six months. July 2007. (accessed Dec 2010).
  • 7. Whiteford H, Doessel D, Sheridan J. Uptake of Medicare Benefits Schedule items by psychologists and other mental health practitioners. Clinical Psychologist 2008; 12: 50-56.
  • 8. Giese J, Lindner H, Forsyth C, Lovelock H. Survey of clients receiving Medicare-funded psychological services under the Better Access Initiative. InPsych: the Bulletin of the Australian Psychological Society Ltd 2008; 30 (4).
  • 9. Australian Longitudinal Study on Women’s Health. (accessed Dec 2010).
  • 10. Brown WJ, Bryson L, Byles JE, et al. Women’s Health Australia: recruitment for a national longitudinal cohort study. Women Health 1998; 28: 23-40.
  • 11. Ware JE, Kosinski M, Keller ST. SF-36 Physical and Mental Health Summary Scales: a user’s manual. Boston: Health Institute, 1994.
  • 12. McCallum J, Shadbolt B, Wang D. Self-rated health and survival: a 7-year follow-up study of Australian elderly. Am J Public Health 1994; 84: 1100-1105.
  • 13. Goldberg D, Bridges K, Duncan-Jones P, Grayson D. Detecting anxiety and depression in general medical settings. BMJ 1988; 297: 897-899.
  • 14. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med 1994; 10: 77-84.
  • 15. Women’s Health Australia. The Australian Longitudinal Study on Women’s Health. Report 16. 10 June 2001. (accessed Dec 2010).
  • 16. Young AF, Dobson AJ, Byles JE. Access and equity in the provision of general practitioner services for women in Australia. Aust N Z J Public Health 2000; 24: 474-480.
  • 17. World Health Organization Consultation on Obesity. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: WHO, 1999.
  • 18. Australian Government Department of Health and Aged Care (GISCA). Measuring remoteness: Accessibility/Remoteness Index of Australia (ARIA). Canberra: DHAC, 2001.
  • 19. Carey T, Rickwood D, Baker K. What does $UD27,650,523.80 worth of evidence look like? Clin Psychol 2009; 13: 10-16.
  • 20. Andrews G, Issakidis C, Carter G. Shortfall in mental health service utilisation. Br J Psychiatry 2001; 179: 417-425.
  • 21. Zhang Y, Chow V, Vitry AI, et al. Antidepressant use and depressive symptomatology among older people from the Australian Longitudinal Study of Ageing. Int Psychogeriatr 2010; 22: 437-444.
  • 22. Byles J, Loxton D, Berecki J, et al. Use and costs of medications and other health care resources: findings from the Australian Longitudinal Study on Women’s Health. Report to the Department of Health and Ageing, June 2008.
  • 23. Australian Government Department of Health and Ageing. Access to Allied Psychological Services (ATAPS). Canberra: DoHA, 2010. (accessed Dec 2010).


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