Disparities in access to and utilisation of Medicare subsidised telehealth mental health services by Aboriginal and Torres Strait Islander Australians in Southeast Queensland

Objective: This study examines disparities in and factors that were associated with the access rates and utilisation of telehealth mental health services by Indigenous Australians in Southeast Queensland.Methods: We analysed the 2021 Census and Medicare Benefits Schedule (MBS) data for 298,283 individuals who accessed MBS-subsidised community mental health services, including 78,048 who accessed telehealth. Descriptive, logistic and linear regression analyses were conducted. Results: Indigenous Australians were significantly less likely to access telehealth than non-Indigenous Australians (24.66% vs. 26.23%, p < 0.001); though difference was small. Video-based telehealth was associated with a significantly greater increase in service use for non-Indigenous Australians than Indigenous Australians (coefficient = -0.76, p<0.001). Indigenous adults who were female, aged 25–69, or not in the labour force were more likely to access telehealth, while utilisation was higher among those aged 40+, those who did not speak an Aboriginal language at home, and those receiving psychotherapies or video-based services. Indigenous children aged 12–17 years and those living in the Gold Coast Hospital and Health Service region had higher telehealth access rates, while higher utilisation was associated with psychotherapies and video services. Conclusions: Compared with non-Indigenous Australians, Indigenous Australians were less likely to access and utilise telehealth services, particularly for video services and psychotherapies, relying more on GP-delivered services and phone consultations. These patterns suggest systemic and cultural barriers, including cost, service availability, and preferences. Tailored telehealth interventions are needed to address these disparities and promote equitable access and utilisation.