Factors associated with Medicare mental health services access and frequency of utilisation by Aboriginal and Torres Strait Islander adults and children in Southeast Queensland

ObjectiveThis study explored differences in access to mental health services between Indigenous and non-Indigenous Australians and identified related sociodemographic and service factors in an urban Indigenous population.MethodsWe analysed linked 2021 Census, 2021 Medicare Benefits Schedule (MBS), and composite Indigenous identifier data from the Australian Bureau of Statistics Person-Level Integrated Data Asset (PLIDA) for 2,494,381 individuals (2.98% Indigenous) in Southeast Queensland (SEQ) residents.ResultsSEQ Indigenous populations had higher rates of access to MBS-subsidised mental health services than non-Indigenous populations. They utilised less total mental health sessions on average, waited more days between mental health care plan and follow-up treatment, had significantly fewer psychotherapy sessions, a higher percentage of bulk-billed sessions, and incurred lower average gap payments. After adjusting for sociodemographic factors, Indigenous individuals still exhibited slightly higher rates of access to MBS-subsidised mental health services. Lower rates of access among Indigenous people were significantly associated with being male, aged 40 years or older, not speaking an Aboriginal language at home, having unstable housing, lower education attainment and no history of mental illness. Higher utilisation was significantly associated with receiving psychotherapy treatment sessions, having a history of mental illness, being unemployed or not in the labour force, aged 40-54 years old, and having a post-secondary degree.ConclusionsWhile overall access rates were slightly higher for Indigenous populations, lower psychotherapy use and longer wait times for follow-ups suggest ongoing inequities. Subgroups like men and those with lower education levels may need targeted interventions for equitable mental health care.