Mental health social work enabling better access

Op-ed by Cindy Smith

Bushfires, floods, mouse plagues, housing stress and COVID-19 have all thrown the mental health needs of people living in regional Australia into sharp relief. While the prevalence of mental illness is roughly the same across Australia, the rates of suicide and self-harm increase with remoteness and reduced access to services.

The rate of suicide in regional, rural and remote areas is 40 per cent higher than in metropolitan areas. Men in these areas aged 15–29 years are almost twice as likely to take their own lives as those in cities.

Aboriginal and Torres Strait Islander peoples, two-thirds of whom live in regional, rural or remote areas, are almost three times more likely than non-Indigenous Australians to report high or very-high levels of psychological distress.

In regional Australia, there can be a stigma attached to seeking help. Young people can face pressure to conform, especially regarding sexual orientation and gender identity. In addition, older people are more likely to be living with a chronic condition, chronic pain or a disability that can exacerbate mental conditions.

Accredited mental health social workers (AMHSWs) have a crucial role to play in helping people in regional Australia with their mental health. The Australian Government recognises the Australian Association of Social Workers (AASW) as an assessing authority of specialist mental health expertise. The accreditation indicates that the social worker is a highly skilled mental health clinician in assessment, treatment planning, complex case formulation and delivery of evidence-based therapeutic interventions across formative and life stages, in collaboration with clients.

AMHSWs are recognised providers of mental health services under the Medicare Better Access Scheme and other government-funded schemes and programs. Mental health social work services are offered under Bupa and Teachers Health private health funds, with discussions underway to add social work services to the offerings of other large private health fund providers.

The AASW conducted a detailed survey of AMHSWs in August 2022. More than 50 per cent of respondents have been social workers for more than 20 years, with 25 per cent having notched up more than 30 years of service.

While AMHSWs are concentrated on the eastern seaboard, 47 per cent work outside metropolitan areas – 31 per cent in regional areas and 16 per cent in rural or remote Australia. Some 57 per cent of their clients present with complex mental health needs.

Given the challenges some men experience in acknowledging or sharing their mental ill health, it is not surprising that 59 per cent of AMHSW clients are female and only 33 per cent are male, with a further eight per cent identifying as non-binary or trans.

More than half of AMHSWs now provide either telephone or video consultations, which has done much to overcome the tyranny of distance and reduce wait times.

Some 93 per cent of AMHSWs reported that clients receive rebates under the Better Access Initiative, while others access other Medicare-rebated schemes (Chronic Disease Management, Eating Disorders and Non-directive Pregnancy Support Counselling). Others are eligible under Victims of Crime, Workers’ Compensation or Transport Accident schemes.

The vast majority of referrals come from general practitioners or by self-referral, at 91 per cent and 83 per cent respectively. Most clients receive a course of treatment ranging from five to 20 sessions within a 12-month period. Nearly three-quarters of AMHSWs have clients who need to be referred to psychiatrists.

Mental health social work offers a person-in-environment approach to mental health interventions, working within a human rights therapeutic framework. We use interventions such as cognitive behavioural therapy (CBT), mindfulness and strengths-based therapies, among many others.

If you need to find a social worker, please use our Find a Social Worker portal.

Originally published in Partyline – 15 December 2022