A friend recently told me about trying to find a psychologist. She had a Mental Health Care Plan from her GP — ten Medicare-subsidised sessions a year. The system working as designed.

Then she started calling. Three weren’t taking new patients. One had a six-week wait. Another could see her in two weeks but charged $260 per session, with a Medicare rebate of $93.35. Gap fee: nearly $170.

She earns $65,000. Has a mortgage and two kids. She couldn’t afford it. So she didn’t go.

This is becoming the norm.

The numbers

The gap between what Medicare pays and what psychologists charge has been widening for years. In Sydney and Melbourne, fees of $250-$300 per session are common. Even in Brisbane, $200-$250 is standard. The result is gap fees that put therapy out of reach for people who often need it most.

A 2025 AIHW report found that cost was the most commonly cited barrier to accessing mental health services — ahead of wait times, stigma, and practitioner availability.

The workforce shortage

Even if money weren’t an issue, there aren’t enough psychologists. The surge in Mental Health Care Plans since the pandemic created demand the workforce can’t absorb, especially in regional areas. The result is a two-tier system: affordable access if you’re urban and well-off, months-long waits (or nothing) if you’re not.

What the government has done (and hasn’t done)

The ten-session Medicare model was expanded from six sessions during the pandemic, which was a positive step. But without adequate rebate increases, more sessions don’t help if people can’t afford the per-session cost.

There have been calls from the Australian Psychological Society, mental health advocacy groups, and the crossbench for a significant increase to the Medicare rebate for psychology services. Some advocates have pushed for bulk-billing incentives similar to those that exist for GP services, to encourage more psychologists to see patients without a gap fee.

Progress has been slow. Meanwhile, demand continues to grow.

The downstream effects

When people can’t access professional mental health support, the consequences ripple outward.

Emergency departments bear the burden. Mental health presentations to Australian EDs have increased substantially. EDs aren’t designed for this, but when people have nowhere else to turn, that’s where they end up.

GPs become the default. They’re doing incredible work but are stretched thin. For conditions requiring structured therapy — trauma, complex anxiety, eating disorders — a GP visit isn’t a substitute.

People turn to unregulated alternatives. When professional help is unaffordable, some seek support from unqualified practitioners or online forums that may do more harm than good.

What can you do right now?

If you’re struggling to access affordable mental health care, here are some options worth exploring:

Ask about bulk-billing. Some psychologists do bulk-bill, meaning there’s no out-of-pocket cost with a Mental Health Care Plan. They’re harder to find, but they exist. Your GP or local Primary Health Network can help identify bulk-billing practitioners in your area.

Community mental health services. State and territory governments fund community mental health teams that provide free services, though eligibility criteria and wait times vary.

University psychology clinics. Many Australian universities run low-cost or free psychology clinics staffed by supervised postgraduate students. The quality of care is often excellent, and fees are typically $20-$40 per session.

Headspace (for ages 12-25) and Head to Health offer free or low-cost services and can help you navigate the system.

Online and phone services. Beyond Blue (1300 22 4636), Lifeline (13 11 14), and the MindSpot Clinic offer free support. These aren’t substitutes for ongoing therapy, but they can provide immediate help and connect you with longer-term options.

The conversation we need to have

Australia talks a good game about mental health. But encouraging people to seek help while making that help unaffordable is a contradiction we can’t keep ignoring.

Mental health care shouldn’t be a luxury item. If you can afford therapy, go — it’s worth it. If you can’t, please don’t feel like a failure. The system is failing you, not the other way around.

Write to your MP. Support organisations advocating for better funding. Keep talking about it.