Australia’s Better Access initiative: A survey of provider and referrer views

OBJECTIVE: Australia's Better Access initiative enables people with mental disorders to be referred for treatment and management through a range of providers. The costs to consumers are offset by Medicare rebates. We examined eligible providers' and referrers' views and experiences with Better Access. METHOD: An anonymous online survey was completed by 2386 participants: 572 clinical psychologists, 1140 psychologists, 398 social workers, 104 occupational therapists, 45 general practitioners and 126 psychiatrists. The survey included questions about processes, outcomes, barriers and facilitators associated with Better Access. RESULTS: Most survey participants (54-99% depending on professional group) had provided Better Access services in 2021. The majority believed Better Access enables them to deliver care that is appropriate, tailored to consumers' needs and achieves good outcomes. However, there were concerns that consumers who require more intensive or linked-up care might not receive adequate care through Better Access. Many providers, particularly allied health professionals, did not have the capacity to take on new consumers, leading to long waiting lists and delayed treatment. High out-of-pocket costs (a flow-on effect of inadequate rebates) were seen as discouraging engagement by consumers on low incomes. Good communication between referrers and providers was seen as a key facilitator of Better Access care, but complicated referral and review processes were identified as impeding communication and disrupting continuity of care for consumers. CONCLUSION: Providers and referrers agreed that Better Access achieves good outcomes for consumers. Strategies to address workforce capacity and affordability for consumers, and to streamline referral and review processes are needed.