Calls to expand telehealth services for psychologists amid pandemic fears

Dominic Giannini 25 March 2020 1
Dr John Brown

Dr John Brown says the Medicare rebates for telehealth services need to be expanded to help clinicians and patients safely engage in appointments during the pandemic. Photo: Region Media.

Psychologists and medical professionals are calling on the Federal Government to extend the Medicare rebate for telehealth services and allow more people to access help remotely during the pandemic.

Currently, a new COVID-19 rebate has been introduced through Medicare for psychologists and clinical psychologists allowing them to bulk bill patients who are forced to self-isolate or self-quarantine for teleservices.

However, these rebates do not apply to people who are not required to isolate, such as those who have chosen to stay home to avoid exposing an elderly parent or child to the virus, something that has to change says clinical psychologist Dr John Brown.

“The efficacy studies show that the outcomes of telehealth are exactly the same as face-to-face. In fact, with some clients there is actually an advantage,” Dr Brown told Region Media.

“There is a structural barrier where clients are not able to get rebates for Skype appointments or video technology. The approach of Medicare to date has been to create special and limited items for Skype appointments. I think that is the wrong approach. What they should be doing is simply removing restrictions on our usual [Medicare benefits] items.”

The current rebate for a psychologist and a clinical psychologist for a 50-minute session is $86.15 and $126.50 respectively, with the COVID-19 benefit for teleservices being the same.

The rebates are less for a half-hour session, $61.05 and $86.15 respectively; however, these are rarely used, said Dr Brown, who is also the director of private psychology service, PsychSessions.

On Monday (23 March), the Australian Medical Association (AMA) and Australian Psychological Society (APS) called on the Federal Government to urgently make the COVID-19 telehealth psychology consultations available to all Australians.

APS Chief Executive Officer Frances Mirabelli said the changes were necessary to protect both patients and clinicians as small consultation rooms mean social distancing requirements are often impossible to adhere to.

“Psychologists need to be able to replace all face-to-face consultations with telehealth consultations immediately but, unfortunately, under the current restrictions on these items this is not possible,” she said.

“Now more than ever, it is important that all Australians are able to access their psychologist in a safe environment. We cannot have clients missing out on their consultations, and we cannot have psychologists and their clients being put at risk.”

In Question Time on Monday (23 March), the Federal Minister for Health, Greg Hunt, said the Government would expand telehealth items for vulnerable health practitioners including those who are over the age of 70, pregnant, immunocompromised, or a parent of a child under 12-months.

He also told Parliament that the Government was working on the fourth stage of its telehealth rollout to co-design a whole of population telehealth response with the industry.

The staged rollout was because there was an important need to maintain face-to-face services for some physical conditions and make sure that smaller general practices are protected.

However, mental health services were not mentioned by the minister. This came as a surprise to Dr Brown, who is at a loss as to why mental health services have not been included already.

“I am not sure of the reasons why they are not in place, maybe it’s a historical hangover,” he said.

“There is research showing that there are misconceptions amongst clinicians about the use of the technology so maybe there are misconceptions amongst bureaucrats as well.”

Telehealth services are nothing new as people in rural and remote areas already have access to Medicare rebates for mental health teleservices under the 2017 Better Access initiative and Dr Brown says he has been using the service for over a decade.

Dr Brown is preparing for an influx of people wanting to access help via video or over the phone in the coming months as the country goes into lockdowns and restricts public interactions.

“Nobody knows what is in the future but our planning at the moment is that all of the psych sessions and clinicians will probably be isolated or quarantined at some point,” he said.

“I hope that that is not the case but I suspect that everyone will be doing this at least some of the time over the next few months.

“I am expecting there to be an increase and once people get used to the technology I am expecting that increased use will continue even after the current virus crisis has passed.”

If you or anyone you know needs help contact Lifeline on 13 11 14 or Kids Helpline on 1800 551 800. If you know someone whose life or safety is in immediate danger, call 000.


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One Response to Calls to expand telehealth services for psychologists amid pandemic fears
Tod Davis Tod Davis 5:22 pm 26 Mar 20

The whole psychology system has pretty much shut down

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