Disparities in the use of Medicare-subsidised telehealth mental health services by Aboriginal and Torres Strait Islander Australians in Southeast Queensland.

Abstract

Objective: This study examines disparities in rates and number of telehealth used among Indigenous Medicare mental health services users in Southeast Queensland.

Methods: We analysed the 2021 Census and Medicare Benefits Schedule data for 298,283 individuals who used MBS-subsidised community mental health services, including 78,048 who used telehealth. Descriptive and regression analyses were conducted.

Results: Indigenous Australians were significantly less likely to use telehealth than non-Indigenous Australians (24.66% vs 26.23%, p < 0.001), although difference was small. Video-based telehealth was associated with a significantly greater increase in service use for non-Indigenous Australians than Indigenous Australians (coefficient = -0.76, p < 0.001). Indigenous adults who were female, aged 25-69, or not in the labour force were more likely to use telehealth, while number of telehealth services used was higher among those aged 40+, those who did not speak an Aboriginal language at home, and those receiving psychotherapies or video-based services. Indigenous children aged 12-17 years and those living in the Gold Coast Hospital and Health Service region were more likely to use telehealth, while greater telehealth utilisation was associated with psychotherapies and video services.

Conclusions: Compared with non-Indigenous Australians, Indigenous Australians were less likely to use telehealth services, particularly for video services and psychotherapies, more likely to rely on general practitioner-delivered services and phone consultations. These patterns suggest systemic and cultural barriers, including cost, service availability, and preferences. Tailored telehealth interventions are needed to address these disparities and promote equitable utilisation.