Not billing Medicare, that’s for sure.
Medicare Mental Health Centres are touted as being a solution for Australians with “moderate to complex mental health needs”, but not much about the new service is clear.
Announced in this year’s budget, the full network of 61 clinics is set to be open by mid-2026 and offer free, walk-in appointments that will “take pressure off the Better Access program to be all things to all people” and “support psychologists to work to their full scope of practice”.
Despite the lofty ambitions, six months down the road there is still next to no information on the type of practitioners at each clinic, what level of complex care is on offer and how they integrate with primary care.
Even the name is a slight obfuscation – Medicare Mental Health Centres do not actually bill Medicare.
If they’re not Medicare, what are they?
A spokesperson for the Department of Health and Aged Care confirmed with The Medical Republic that the centres are block funded outside of the MBS, and that staff are salaried.
The funding itself flows through local Primary Health Networks, which are commissioned to find providers for individual clinics.
Technically, MMHCs are not new; the majority are rebranded Head to Health centres.
According to its official website, Head to Health is “a free confidential service from the Australian government”.
At one point, it had (or was meant to have) a physical presence in every state and territory, with various satellite clinics set up within existing primary care services.
In the 2019-20 budget, Head to Health received $14.5 million over five years to trial eight physical clinics.
In the 2021-22 budget DoHAC invested another $487.2 million to expand the network and in the 2023-24 budget a total of $9.6 million was allocated to Head to Health.
This year’s budget included $29.8 million, this time for MMHCs.
As of December 2024, the only remnants of Head to Health are a website, an 8:30am-to-5pm weekday phone service, six clinics in Victoria and a national service model.
It’s this service model which still forms the basis of the MMHCs.
Who works there?
This is the biggest question.
There was $29.9 million in the budget specifically to enable each centre to provide free on-call access to a psychologist and psychiatrist.
An FAQ on the MMHC webpage implies that these services are not available at every clinic right now.
“Medicare Mental Health Centres will soon also provide enhanced services, including free access to a psychologist and psychiatrist either in person or via telehealth,” it reads.
Because each centre is meant to be designed in consultation with the local community, there are no hard rules on the types of providers who work there.
Staff from MMHCs tell TMR that their staffing mix includes psychologists or provisional psychologists, social workers, integrated mental health workers (people with a counselling degree), and emotional wellbeing officers.
As per the Head to Health service model document, centres are expected to employ “a range of multidisciplinary clinical, peer support and administrative staff, as deemed most relevant to the local setting, within recruitment capability”.
At a minimum, each clinic is expected to have capacity to respond in-house to people experiencing a crisis, to provide a central point of connection to other services, to perform biopsychosocial assessments and short- to medium-term care.
Medical assessments, psychological assessments and structured psychological therapies are also listed as core services that can be delivered in-house, on referral or on an in-reach basis.
Where the government will find this workforce is unclear.
Speaking to The Medical Republic earlier this year, then-RACGP president Dr Nicole Higgins said that while GPs were in short supply, so were psychiatrists, psychologists and other mental health professionals.
“GPs are the first point of contact for many people seeking mental health support and funding should reflect that,” she says.
“It needs to be as easy as possible for patients facing mental health struggles to get help.
“The intent behind these mental health centres would seem to be to enable that, but anyone who has or knows someone who has needed psychological help knows people need more opportunities to get help.”
As recently as March this year, the Royal Australian and New Zealand College of Psychiatrists sent an open letter to the Health Minister calling for urgent investment to grow the psychiatry workforce.
“With more people needing mental health care than ever, the system is unable to cope, and our most vulnerable people are falling through the cracks,” the letter says.
“And on the other side is a workforce working tirelessly to do the best for their patients while on the verge of burnout.”
Who gets seen there?
Because the service isn’t funded by Medicare, technically anyone can be seen at an MMHC.
One of the consistent features across the various models is that all of them are walk-in, rather than appointment based.
No referral is needed, nor is a GP mental health care plan.
“It’s not yet clear to us that the 61 Medicare Mental Health Centres will guarantee continuity of care with a patient’s usual GP,” Dr Higgins said.
“We support greater investment in accessible mental health services, but appropriate handover and communication with a patient’s regular GP is essential.”
MMHCs are intended to fill a gap for people with moderate to high levels of mental health need; crucially, because they are meant to be walk in, MMHCs do not have capacity to treat patients long term.
Coffs Harbour MMHC psychologist and clinical services manager Emma Schubert tells TMR that patients are triaged using an initial assessment and referral tool and given an acuity score between one and five.
“Medicare mental health centres work with people between the two and the four,” she says.
“A two could work with our peer worker, or could do a very brief intervention.
“A person who gets a score of four would be quite unwell, probably have some suicide risk and the most appropriate treatment will be from a clinician.
“We … acknowledge that not everybody needs the same treatment or the same clinician.”
At Coffs Harbour, she says, around 5% of patients have been categorised as four and the bulk have been categorised as three.
“Some people present with emerging mental health stuff like depression, anxiety or PTSD … a huge portion of our caseloads have existing childhood trauma, which usually isn’t the presenting issue – it’s just something else that’s there,” Ms Schubert said.
“But I would say [there is] quite a broad range of presentations, and this is exactly what a Medicare mental health centre is meant to do – do an assessment, figure out what kind of care people need and make it easy.”
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Where are they?
The promise in the budget was that there would be 61 MMHCs across the country, built off the existing or planned Head to Health services.
So far, around half of those are listed as being open on the DoHAC website.
One of the curious aspects of MMHC distribution is that, of the 61 clinics, 19 were earmarked for Queensland and 22 for NSW.
According to the DoHAC webpage, Western Australia got five and four have opened in South Australia.
That leaves just 11 to cover the entirety of Victoria, Tasmania, the Northern Territory and the ACT, assuming no more open in WA and SA.
It’s unclear if the six Head to Health clinics remaining in Victoria count toward the total 61 clinics; assuming they do, that leaves five.
There’s also one MMHC branded clinic in Geelong, leaving four for Tasmania, the ACT and the NT.
Each of those jurisdictions have one clinic open, leaving just one unassigned MMHC in the mix.
Going strictly by population distribution, one would expect 18 clinics in NSW, 15 in Victoria, 12 in Queensland, six in WA, four in SA and one each in the remaining three jurisdictions, with three left over to distribute as needed.
