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. 2026 Mar;60(1_suppl):35-48.
doi: 10.1177/00048674251405142. Epub 2026 Mar 3.

Examining the effectiveness of the Better Access initiative using data from real-world practice settings

Jane Pirkis  1 , Ben Buchannan  2 , Philip Burgess  3   4 , Kaye Frankcom  5   6 , Aaron Frost  7 , Meredith Harris  3   4 , Chris Mackey  8 , Leo Roberts  1 , Katrina Scurrah  1 , Matthew J Spittal  1 , Caley Tapp  3   4 , Dianne Currier  1
Affiliations

Examining the effectiveness of the Better Access initiative using data from real-world practice settings

Jane Pirkis et al. Aust N Z J Psychiatry. 2026 Mar.

Abstract

Objective: This study examined the effectiveness of the Better Access initiative using outcome data from real-world practice settings.

Methods: We used anonymised data from four datasets to assess outcomes for consumers over 86,121 episodes of care. The datasets contained routinely captured episode-level data from the practices of psychologists and other eligible Better Access providers. Across the datasets, outcomes were assessed on 11 different measures (mostly consumer-rated measures of depression and anxiety symptoms, psychological distress, functioning and wellbeing). We conducted purpose-designed analyses with three of the datasets (83,346 episodes), examining score changes on given measures between the first and last assessment occasion within an episode. We used preexisting outputs for the fourth dataset (2775 episodes), again considering change from the beginning to the end of the episode.

Results: In the purpose-designed analyses, consumers' mental health improved in around 50-60% of episodes. However, consumers showed no change or experienced deterioration in their mental health in 20-30% and 10-20% of episodes, respectively. Those with more severe baseline scores had a greater probability of showing improvement. The preexisting outputs also identified significant improvements, particularly in episodes where treatment was complete.

Conclusion: Better Access is achieving reductions in symptoms and improvements in functioning and wellbeing for the majority of consumers. A minority of consumers do not have these sorts of positive outcomes, however, and further work is required to understand why. Routine measurement of outcomes - particularly consumer-rated outcomes - would enable ongoing monitoring of the extent to which Better Access is achieving its goals.

Keywords: Better Access; Medicare; Psychological therapy; mental health services.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: B.B. is the co-founder and director of NovoPsych; K.F. is the director of Kaye Frankcom Consulting, A.F. is a co-director of Benchmark Psychology and C.M. was the director of Chris Mackey and Associates.

Figures

Figure 1.
Figure 1.
Outcomes by measure.
Figure 2.
Figure 2.
Outcomes by measure and baseline severity.
Figure 3.
Figure 3.
Outcomes on the ORS for active and inactive clients, by period.
See this image and copyright information in PMC

References

    1. Allen NB, Jackson HJ. (2011) What kind of evidence do we need for evidence-based mental health policy? The case of the Better Access initiative The Australian and New Zealand Journal of Psychiatry 45: 696–699 - PubMed
    1. Angst F, Aeschlimann A, Angst J. (2017) The minimal clinically important difference raised the significance of outcome effects above the statistical level, with methodological implications for future studies. Journal of Clinical Epidemiology 82: 128–136 - PubMed
    1. Arya V, Tapp C, Currier D, et al. (2026) Examining Better Access use by Australian adults using data from two longitudinal studies (Ten to Men and the Australian Longitudinal Study on Women’s Health). Australian and New Zealand Journal of Psychiatry 60: 74–94. - PMC - PubMed
    1. Australian Bureau of Statistics (2022) National Study of Mental Health and Wellbeing. Summary Statistics on Key Mental Health Issues Including the Prevalence of Mental Disorders and the Use of Services. Reference Period 2020-21. Available at: https://www.abs.gov.au/statistics/health/mental-health/national-study-me... (accessed 27 June 2023).
    1. Australian Government Department of Health (2021) Better access initiative. Available at: https://www.health.gov.au/initiatives-and-programs/better-access-initiat... (accessed 26 June 2021).

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