Telehealth changes limiting access to mental healthcare
26 February 2026
Peak body for all psychologists, the Australian Association of Psychologists Inc (AAPi), says Medicare changes relating to mental health telehealth services implemented late last year are creating barriers to care and must be reviewed.
Last November, GP mental health telehealth items, including Mental Health Treatment Plans, reviews and referrals, were no longer exempt from the “established clinical relationship” requirement.
In effect, this means that unless a patient has attended an in-person consultation with a GP in the previous 12 months, the GP cannot provide their services via telehealth.
AAPi Executive Director Tegan Carrison said the impact of this change had been significant for people in regional, rural and remote areas.
“People in need of mental health care are now having to travel extensive distances to attend a face-to-face GP appointment. There can also sometimes be an extensive wait time to see a GP, of six to eight weeks or more,” she said.
“The workforce shortage also means there can be limited availability of GPs in these areas.”
Ms Carrison said for many Australians, attending a GP in person was difficult and a genuine barrier to care.
“This includes people experiencing severe anxiety, agoraphobia or trauma-related conditions; people with a disability, chronic illness or mobility limitations; those experiencing domestic violence; and anyone with a caring responsibility who cannot leave home easily.
“Often, patients have established long-term, therapeutic relationships with GPs via telehealth, sometimes over several years. Despite clear clinical continuity and established trust, these patients are being forced to attend an in-person consultation before care can continue.
“This change disrupts continuity of care and creates unnecessary barriers for vulnerable people.
“Telehealth has been proven as a safe and effective access pathway and should not be withdrawn without clear evidence of harm.”
Ms Carrison said while there are circumstances where a GP may appropriately require a patient to attend in person - for example, where a physical examination is clinically indicated - this decision should ultimately rest with the GP.
AAPi is calling for:
- Reinstatement of the exemption for a GP to provide mental health-related services, including Mental Health Treatment Plans (MHTPs), reviews and referrals, without having to see the client face-to-face, if that is in the best interests of the patient.
- Greater flexibility for patients in rural and remote areas
- Recognition of established, ongoing therapeutic relationships, even where these have occurred via telehealth rather than in person.
“This approach would protect continuity of high-quality, team-based care, ensure privacy and safety for vulnerable patients and maintain equitable access regardless of geography or circumstance,” Ms Carrison said.
“Mental health care is relational and often long-term. Policy settings must balance continuity, quality and access, not inadvertently dismantle effective models of care.
“Equitable access to mental health care should not depend on postcode, or a patient’s ability to travel.”
Case Studies
Clinical psychologist Olivia Clayton (member of AAPi) is the Director of Collected Minds, a rural online psychology practice based in Mansfield, Victoria and serving communities nationwide. She leads a multidisciplinary team of psychologists, mental health social workers and mental health-trained GPs who consult via video.
Ms Clayton acknowledged the Government’s focus on ensuring telehealth is delivered safely and as part of high-quality, ongoing care.
“The MBS Review Advisory Committee noted that telehealth works best when it is part of ongoing care for familiar patients, and I completely agree with that principle,” she said.
“They are concerned about lower quality and low-value care when telehealth is not used optimally. However, Recommendation 7 of their report advised retaining eligibility exemptions for telehealth GP mental health items and recognised the importance of telehealth for people in rural and workforce-limited settings.”
Ms Clayton said the recent change may not fully reflect that recommendation, particularly for rural patients who have established, ongoing relationships with mental health-trained telehealth GPs.
“The impact has been immediate and distressing for some patients,” she said.
“Rural patients often face long wait times to see a GP with mental health expertise, significant travel distances, and in small communities may prefer to see someone who is not part of their social or professional network.
“Longstanding therapeutic relationships between patients and telehealth GPs are now being disrupted, fragmenting coordinated models of care that have operated successfully for years.”
Ms Clayton said a practical solution would be to retain the exemption to the “established clinical relationship” requirement for telehealth GP mental health services delivered by appropriately trained GPs to patients in rural and remote areas.
“This would preserve continuity of care while still addressing concerns about low-value or impersonal telehealth services,” she said.
Ms Clayton said many of Collected Minds’ clients were people living in and around the Longwood bushfire-affected area
“This is not the time to be making it harder for these people. At a time when rural communities are managing repeated natural disasters, policy settings should be reducing friction, not increasing it.”
She has written to the Federal Department of Health requesting the matter be reviewed.
Megan Gomez (member of AAPi) is the founder of Rural Health Connect, a telehealth platform with 420 psychologists delivering bulk-billed and low-cost sessions. Last year, it provided more than 28,000 appointments across rural Australia.
“Much of our service supports people in remote locations, disaster-affected communities, and individuals facing longstanding barriers to accessing in-person care,” Ms Gomez explained.
“Previously, the platform also facilitated access to GPs who could prepare Mental Health Treatment Plans via telehealth in areas where no local GP was available or where practices had closed their books. These services were widely used by patients with limited alternatives.
“Under the new face-to-face requirements, telehealth GP services are no longer permitted, leaving us with no option but to turn some patients away.”
About the Australian Association of Psychologists Inc (AAPi)
The AAPi is a not-for-profit peak body for all psychologists that aims to preserve the rich diversity of psychological practice in Australia. Formed in 2010 by a group of passionate grassroots psychologists, the AAPi’s primary goal is to address inequality in the profession and represent all psychologists and their clients equally to government and funding bodies. Its primary mission is to lobby for equitable access for the Australian public to professional psychological services such as Medicare Better Access Scheme and the National Disability Insurance Scheme.
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