Most people are aware that the government recently withdrew support for the additional 10 Medicare rebated counselling sessions introduced at the beginning of the COVID pandemic. It is fair to say there has been significant public concern about withdrawing a service from people who genuinely need more than the current 10 sessions offered. Given the recent changes, it seems an appropriate time to take a closer look at what is being provided by health practitioners when it comes to mental health care; what services are effective at treating various presenting mental health problems and what policy makers should be doing to change with the evolving science.
We believe the Australian Government should consider the inclusion of dietetic and exercise services under a mental health care plan, which could facilitate a person engaging with a credentialed practitioner such as a psychologist, dietitian and/or exercise professional for a specific mental health problem. Being able to access 20-25 Medicare rebated sessions a year with a range of allied health practitioners who offer evidenced based treatment would be a good start.
Why should a mental health care plan incorporate dietetic and exercise, as well as counselling? Well, the reason is quite clear. Both exercise and supervised dietary interventions have shown to be effective in the treatment of mental health problems. One review highlighted the effectiveness of supervised dietary modification in the management of severe mental health presentations. The evidence continues to develop in this area with the Food and Mood Centre engaged in some exciting research. Another review in the physical activity literature found exercise to be a more effective treatment when compared to counselling and medication treatments. The more intense the exercise, the better the outcome the authors say.
A large scale review in 2020 recommended that lifestyle modification such as the introduction of exercise, dietary change, improved sleep and reduction in alcohol/substance should be the first line of treatment for mood disorders, over and above pharmacological treatments. This was a game changer and highlights the holistic approach mental health requires in the future.
It is time we considered the benefits of other services such as exercise and dietetics for various mental health problems. To provide an example about how this could work in practice, you could go to your doctor with a problem such as depression. The GP could recommend a mental health care plan that enabled you to utilise the skills of a psychologist, exercise physiologist and dietitian to make the necessary changes to mitigate depressive symptoms. If you have a problem such as Post Traumatic Stress Disorder (PTSD), you could access the same mental health care plan, but the services could be more so tailored towards psychology and exercise. Dietetics could be part of this treatment approach in the future if the science continues to show promise in its efficacy, although it is still early days.
Imagine getting access to a mental health care plan that enabled you to get rebated sessions every year with a variety of credentialed allied health professionals. We believe this is the way of the future.
The evidence is telling us we need to start approaching mental health issues from a whole of person perspective which includes how a person moves (physical activity), what a person eats (dietetics) and how they think (psychology). Based on the latest scientific evidence, psychological, dietetic and exercise interventions in combination could provide a powerful antidote for certain mental health problems moving forward into the future.
We hope the Australian Government and other bodies such as Australian Psychological Society are considering how best to include these services in mental health care plans moving forward.