Rising Therapy Costs Widen Mental Health Access Gap in Australia
30 Oct 2026
The study examined tax and Medicare records for 5.4 million Australians who received a GP Mental Health Treatment Plan between 2014 and 2023. Researchers looked at whether patients accessed Medicare-subsidised psychological services within three months of receiving their plan.
The findings showed a clear gap between people on lower and higher incomes.
By 2023, only 32% of children and 40% of adults from lower-income households had accessed psychotherapy within three months. This compared with 55% of children and adults from higher-income households.
Researchers found that rising treatment costs were a major barrier. Average out-of-pocket expenses for psychological sessions more than doubled over the study period.
For children, the average cost increased from about $44 to $90 per session. For adults, it rose from $35 to $80.
The researchers linked this increase to psychologist fees rising by 12%, while Medicare rebates increased by just 1.3% over the same period.
The proportion of psychological services provided without an out-of-pocket fee also fell. For children, it dropped from 44% to 17%, while for adults it decreased from 50% to 23%.
The authors said Medicare subsidies under the Better Access initiative were designed to make psychological treatment more affordable. However, provider fees have increased faster than rebates, leaving patients to cover a larger share of the cost.
The findings are also consistent with the Australian Bureau of Statistics' 2024–25 Patient Experience Survey. It found that around one in four people who needed to see a psychologist delayed or missed treatment because of the cost.
GPs Report Growing Pressure on Mental Health Care
Chair of the RACGP Specific Interests Psychological Medicine, Dr Karen Spielman, said the research reflected concerns already being seen in general practice.
She described the findings as important and said the financial barriers highlighted in the study had been a concern for many years.
Dr Spielman explained that GPs are often willing and trained to provide mental health support, but face challenges including limited consultation time, costs, fragmented services and financial pressures.
She also highlighted the growing reliance on antidepressants among people from lower-income areas without accompanying psychological treatment.
The researchers found that people in disadvantaged neighbourhoods were more likely to receive psychiatric medication without psychotherapy than those in higher-income areas.
Dr Spielman said GPs increasingly manage mental health conditions, including prescribing and monitoring medication. She also noted that pressure on specialist and hospital services can mean GPs need to provide treatment earlier.
She added that GPs often work with the resources available to them while managing increasingly complex patient needs.
Researchers Call for More Affordable Mental Health Services
The study highlights the need for policies that reduce the financial barriers preventing people from accessing psychological care.
The researchers recommended several possible measures, including:
- Increasing Medicare rebates for psychological services.
- Introducing targeted financial support for lower-income households.
- Expanding services that offer treatment at reduced fees.
- Exploring bulk-billing incentives for psychological services.
They also called for greater workforce capacity, including more psychologists, psychiatrists and consumer support workers.
Dr Spielman said GPs should receive greater recognition and support as key providers of mental health care, helping more patients receive treatment in the community.
The researchers concluded that improving affordability is essential to ensuring Australians can access timely and appropriate mental health support, regardless of their income.
Rising Therapy Costs Widen Mental Health Access Gap in Australia
Source: Research published in The Lancet Regional Health – Western Pacific; Australian Bureau of Statistics Patient Experience Survey 2024–25.