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10 Jul 2017

There were some welcome and positive mental health initiatives in the Budget.

The big ticket item was $80 million of additional funding to maintain community psychosocial services for people with mental illness who do not qualify for the NDIS. This measure showed that Minister Hunt took on-board concerns the AMA and others raised about people falling through the cracks that exist between the NDIS and State and Territory community services. The Parliament of Australia Budget Review Index[1] explains this measure in detail:

“‘Psychosocial disability’ describes the ‘disability experience of people with impairments and participation restrictions related to mental health conditions’. State and territory governments have primary responsibility for funding psychosocial support services (community mental health services), but the Australian Government also provides funding. Some government funding is transferring to the National Disability Insurance Scheme (NDIS) as it is gradually implemented across Australia. However, not all people with psychosocial disabilities have conditions that fulfil the severity and permanency criteria for accessing NDIS Individually Funded Packages (an impairment condition may be considered permanent even if it varies in intensity or is episodic). In 2019–20 approximately 64,000 NDIS participants are expected to have a significant and enduring primary psychosocial disability, fewer than the estimated ‘230,000 Australians with severe mental illness [who] have a need for some form of social support’. Australian governments have committed to providing continuity of support for people who currently receive services and who will be ineligible for the NDIS. Nevertheless, stakeholders expressed concern at a lack of clarity about these arrangements.

To address these concerns, the 2017–18 Budget allocates $80.0 million over four years from 2017–18 to fund psychosocial support services for people ‘with severe mental illness resulting in psychosocial disability’ who are not eligible for the NDIS but are ‘existing clients of Commonwealth-funded psychosocial services’, such as the Partners in Recovery, Day to Day Living Program and Personal Helpers and Mentors programs. The funding is to be delivered through regional Primary Health Networks (PHNs), which have previously been barred from commissioning psychosocial support services.[NOTE: This has not been officially confirmed yet]. The Department of Health states that ‘Commonwealth investment will be delivered once an agreement has been reached’ with state and territory governments confirming their ‘appropriate’ contributions. Arrangements for the transition period are unclear, as is what will happen if state and territory governments do not agree to provide this funding.”

Other Budget measures included a $9 million allocation for a telehealth initiative to improve access to psychologists for people living in rural and remote areas. An extra $15 million was allocated for mental health research initiatives. This includes $5 million to complete work on Orygen’s National Centre for Excellence in Youth Mental Health in Melbourne, $5 million to establish the Sunshine Coast Mind & Neuroscience Thompson Institute as a leading Australian mental health research hub, and $5 million to establish a Centre for Research Excellence on Prevention of Anxiety and Depression, led by the NSW-based Black Dog Institute and the Hunter Institute.

The mental health sector mostly welcomed Minister Hunt’s dedication to mental health reform, however Dr Sebastian Rosenberg, Senior Lecturer, Brain and Mind Centre, University of Sydney, wrote in The Conversation[2] that the $115 million in new funding over four years “is one of the smallest investments in the sector in recent years.” Dr Rosenberg pointed out that in 2014-15, mental health received around 5.25 per cent of the total health budget, although mental health represents 12 per cent of the total burden of disease. He was critical of the Budget for lacking an overall “coherent national strategy to tackle mental health [and that] outside of primary care such as general practice, or Medicare-funded services (such as psychology services provided under a mental health care plan), mental health services in the community are hard to find.”

The 2017 Budget also saw the funding for the NDIS addressed with a 0.5% increase in the Medicare levy from July 2019. This would increase the levy to 2.5%, raising $8.2 billion over the budget period.  Raising the levy by 0.5 percentage points for all taxpayers (from the current 2 per cent of taxable income to 2.5 per cent), is expected to raise $3.55 billion in 2019-2020, and another $4.25 billion the following year. The Government says this will ensure the NDIS can become fully operational by 2020. This legislation is, at present, yet to be passed by the Senate.

In the Budget there was also an announcement of $209 million over four years for a new NDIS Quality and Safeguards Commission, a national, independent regulatory body that will oversee delivery of services to all NDIS participants. The Commission will commence operations on 1 January 2018 replacing the the array of quality and safeguarding arrangements in place for each State and Territory with the intention of delivering a nationally consistent quality and safeguarding system for the first time.




Published: 10 Jul 2017