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In 2006, Australia introduced new publicly funded psychological services
for people with affective and anxiety disorders (the Better Access
programme). Despite massive uptake, it has been suggested that Better
Access is selectively treating socioeconomically advantaged people,
including some who do not warrant treatment, and people already receiving
To explore potential disparities in Better Access treatment using
epidemiological data from the 2007 National Survey of Mental Health and
Logistic regression analyses examined patterns and correlates of service
use in two populations: people who used the new psychological services in
the previous 12 months; and people with any ICD–10 12-month affective and
anxiety disorder, regardless of service use.
Most (93.2%) Better Access psychological services users had a 12-month
ICD–10 mental disorder or another indicator of treatment need. Better
Access users without affective or anxiety disorders were not more
socioeconomically advantaged, and received less treatment than those with
these disorders. Among the population with affective or anxiety
disorders, non-service users were less likely to have a severe disorder
and more likely to have anxiety disorder, without a comorbid affective
disorder, than Better Access users. Better Access users comprised more
new allied healthcare recipients than other service users. A substantial
minority of non-service users (13.5%) had severe disorders, but most did
not perceive a need for treatment.
Better Access does not appear to be overservicing individuals without
potential need or contributing to social inequalities in mental
healthcare. It appears to be reaching people who have not previously
received psychological care. Treatment rates could be improved for some
people with anxiety disorders.
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