Who uses Better Access treatment services? A re-analysis of data from the usual care arms of two randomised controlled trials

OBJECTIVE: To describe characteristics, service use and clinical changes among people who received treatment through Australia's Better Access programme. METHODS: We re-analysed data from the usual care arms of two randomised controlled trials of tailored care approaches for depression and anxiety in primary care (Target-D, 2016-2019; Link-me, 2017-2019). Participants completed measures of depression and anxiety symptoms, quality of life and days out of role due to psychological distress over 12 months. They reported the use of mental health services from different providers/settings; from this, we classified a subset as likely Better Access treatment users. RESULTS: Of 394 Target-D and 547 Link-me participants, one-third were classified as having used Better Access treatment sessions over 12 months. They used five to seven Better Access sessions on average; half to two-thirds paid out-of-pocket costs (median $78-$89 per session). The number of Better Access sessions and other mental health services they used increased with severity of mental health problems. At baseline, Better Access treatment users reported more severe symptoms and more days out of role than those who used other or no mental health services, and poorer quality of life than those who used no services. Approximately half (43-55%) of Better Access treatment users showed improvements in mental health over 12 months. Among those with severe problems, improvements in depression and anxiety symptoms were associated with using 5+ Better Access sessions. CONCLUSIONS: Better Access treatment is used by people with different levels of mental health need. Many experience improvements in their mental health and functioning.