This chapter considers Evaluation Question 3: To what extent has the Better Access initiative provided equitable access to populations in need? (in particular people living in rural and remote areas, children and young people, older persons, people from culturally and linguistically diverse backgrounds)? Specifically, the chapter brings together data on Better Access service utilisation with information about the prevalence of mental health problems (from the 2007 NSMHWB) and other Division–based characteristics. Together, these data inform a modeling exercise that describes levels of mental health treatment need in areas defined by the boundaries of Divisions of General Practice and investigates whether Better Access services are being distributed according to need.
The analyses presented in Chapter 3 and Chapter 4 examined whether particular groups (e.g., children and young people, older persons, people living in rural and remote areas, people of low socio-economic status) are proportionally represented in the Better Access uptake data, compared to their overall representation in the population. However, these analyses rely on the assumption that mental health problems are evenly distributed across population groups, which is known not to be the case. The analyses presented in this chapter attempt to overcome this problem by adjusting the population comparators to take into account the prevalence of mental health problems among certain groups, using data from the 2007 NSMHWB. The methodology is informed previous analyses.34, 35, 37
The analyses presented in this chapter address Evaluation Question 3 via the following series of research questions:
- What is the distribution of mental health need at the individual level?
- What is the relative distribution of mental health need across Divisions of General Practice?
- What is the relative distribution of Better Access and allied health Better Access services used across Divisions of General Practice?
- What are the rates of Better Access and allied health Better Access services according to key Division characteristics?
- What is the relationship between mental health needs and Better Access services used at the Division level?