Opinion: Australians Turning into Chemical Mental Health Depositories

By Philip Armstrong

New figures released last week by the Australian Institute of Health and Welfare paint a dire picture for Australians who are becoming reliant on chemical interventions for their mental health.

  • 42.7 million mental health-related medications (subsidised and under co-payment) were dispensed in 2020–21.
  • 4.5 million patients (17.7% of the Australian population) filled a prescription for a mental health-related medication in 2020–21, with an average of 9.4 prescriptions per patient.
  • 62.3% of mental health-related prescriptions filled were subsidised by the Pharmaceutical Benefits Scheme (PBS)/ Repatriation Pharmaceutical Benefits Scheme (RPBS) in 2020–21.
  • 84.7% of mental health-related prescriptions filled were prescribed by GPs; 7.5% prescribed by psychiatrists, 4.9% were prescribed by non-psychiatrist specialists in 2020–21.
  • 73.1% of mental health-related prescriptions filled were for Antidepressant medications in 2020–21.

Australians Turning into Chemical Mental Health Depositories

The most disturbing figure is that 84.7% of prescriptions were prescribed by GPs who have minimal formal training in mental health, usually a 20-hour course[1], and have no mandatory requirements to undergo annual ongoing professional development (PD) or clinical supervision. To be fair to GPs, when would they have the time?

The cost to Australians in 2019-20 for government-subsidised mental health-related prescriptions under PBS/RPBS was $566 million[2]. This doesn’t take into account that Australians pay a gap fee up to $42.50 for most PBS medicines or $6.80 if they have a concession card.

Take into consideration a study published in World Psychiatry “The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons (2013)” concluded that pharmacotherapy and psychotherapy have comparable effects in several depressive and anxiety disorders[3]. With 73.1% of prescriptions being for depression brings into question why the government isn’t making counselling available to the public through the Medicare Benefits Schedule (MBS). Surely giving Australians access to a non-chemical alternative is in everyone’s interest, bar the pharma’s.

Australians Turning into Chemical Mental Health Depositories

What would the annual cost to MBS for 3,000 Registered Counsellors and Psychotherapists to be able to offer ten 1-hour sessions to Australians suffering from depression? Answer: less than $250 million a year. Compared to $556 million for prescriptions alone, which doesn’t consider the added cost of people taking prescriptions who are also seeing a psychologist under MBS rebates.

It’s time Registered Counsellors and Psychotherapists became a part of the Medicare system to give Australians a choice between chemical interventions or equally effective counselling services delivered by humans.

[1] General Practice Mental Health Standards Collaboration (2022). https://mentalhealth.racgp.org.au/guidelines/index/616b4fb1-9755-464b-9b04-30228eb78572.

[2] AIHW (2022). https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/expenditure-on-mental-health-related-services.

[3] World Psychiatry (2013). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683266/.