Psychiatrists support Grattan Institute recommendations but say chronic underfunding of the mental health system is making people miss out on affordable and accessible psychiatric care. 

How psychiatry differs from other specialties

Unlike most specialists who perform procedures covered by private insurance, psychiatrists rely almost entirely on Medicare for outpatient care that commonly involves detailed consultations rather than procedures. Due to the complexity involved in providing mental health services, private health insurers do not cover outpatient consultations with psychiatrists in private consulting rooms or clinics, and only partially cover inpatient mental healthcare at private hospitals.  

Psychiatry consultations are also much longer - typically 60-90 minutes compared to 30-45 minutes for other specialists. Private and public psychiatrists also treat completely different patient groups. 

RANZCP President Dr Astha Tomar said: “Most private psychiatrists are filling a critical gap by treating people in the 'missing middle' - patients who are too unwell for their GP but not sick enough for an overwhelmed public system that only deals with severe, complex cases in hospitals. 

"Unlike other specialties, private psychiatrists aren't providing an alternative to public care - they're treating people who have nowhere else to go." 

Medicare rebates not keeping up with costs

Medicare rebates haven't kept pace with rising practice costs. While expenses like insurance, rent and administration rise with inflation at around 3% annually, Medicare rebates have only increased 1.2% to 2.5% over recent decades.  

Private psychiatrists also spend significant time doing administrative work like writing detailed notes outside consultations to manage complex cases - essential work Medicare doesn't cover but is needed to maintain quality and continuity of care. 

Dr Tomar said: “While individual psychiatrists set their own fees to maintain viable practices and continue providing critical mental health support, the College recognises that high costs create barriers that must be addressed. The vast majority of our members in the private sector want to keep costs down for patients while ensuring they can keep their doors open to them.” 

Supporting Grattan Institute recommendations about improving access to specialist care

The RANZCP supports key recommendations made by the Grattan Institute report, including investment in public specialist clinics, growing the workforce through flexible training models, and structural changes to improve affordability of specialist care. 

Dr Tomar said: "We need more psychiatrists, well-resourced public mental health services, and Medicare rebates reflecting real costs of providing safe and high-quality mental health treatment and ongoing care.  

"We're committed to working with governments at all levels and the rest of the sector to ensure no one misses out on mental health care because of where they live or what they can afford.” 

ENQUIRIES: For more information, or to arrange an interview call Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org.  

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org. 

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In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.