澳大利亚研究发现，2014-2023年间心理治疗的可及性出现严重不平等现象，低收入社区居民获得治疗的比例大幅下降。1 数据显示，低收入家庭的儿童在获得心理健康治疗计划后三个月内接受心理治疗的比例从2014年的56%跌至2023年的32%，同期高收入家庭的儿童比例从70%降至55%。1 成人方面，低收入社区的比例从53%下降到40%，而高收入社区从61%降至55%。1 儿童群体受到的冲击尤为严重，十年间低收入社区儿童接受心理治疗的比例下降了24个百分点。1
费用上升被认为是可及性不断恶化的主要驱动因素。1 首次心理治疗的平均自费额大幅攀升，儿童咨询费用从约44澳元上升至90澳元，成人从35澳元上升至80澳元（已调整通胀，以2023年澳元计）。1 这一费用压力直接影响了患者的治疗决策。2024-25年澳大利亚统计局患者体验调查显示，约四分之一需要看心理医生的人因费用而延迟或放弃治疗。1 目前Medicare对心理医生的补偿金额为149.05澳元，远低于建议收费标准330澳元（45-60分钟咨询）。1 COVID疫情期间收入差距特别急剧扩大。1
Over the past decade, a significant gap has emerged in Australians' access to psychological care based on income level, with residents from lower-income communities increasingly unable to obtain treatment.1 Between 2014 and 2023, the proportion of low-income children receiving psychological therapy within three months of accessing a treatment plan fell sharply from 56% to 32%, while the rate for high-income children declined more modestly from 70% to 55%.1 Among adults, therapy uptake in low-income communities dropped from 53% to 40% during the same period, compared to a decline from 61% to 55% in high-income areas.1 This ten-year decline represents a 24-percentage-point drop for low-income children, far exceeding the 15-percentage-point decline observed in affluent communities.1
Rising costs and provider shortages are driving this disparity.1 Out-of-pocket expenses for a first psychological consultation have roughly doubled over the study period, increasing from approximately 44 Australian dollars to 90 Australian dollars for children and from 35 to 80 Australian dollars for adults, adjusted for inflation in 2023 dollars.1 The gap between government Medicare reimbursements—set at 149.05 Australian dollars—and recommended fees of 330 Australian dollars for a 45 to 60-minute session has forced many families to forgo treatment.1 According to the 2024-25 Australian Bureau of Statistics patient experience survey, approximately one-quarter of those needing psychological care delayed or abandoned treatment due to cost.1 The COVID-19 pandemic period saw income-related access disparities widen particularly sharply.1
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