Rural Australians are delaying mental health care or going to emergency departments in crisis after changes to Medicare inadvertently created barriers to treatment.
The changes, which came into effect in November 2025, require patients to see a GP at least once a year to access mental health care via telehealth.
The move was designed to improve continuity of care, ending an exemption that allowed greater telehealth access during the COVID-19 pandemic.
But rural Australians who are less likely to have a regular GP are being disadvantaged by the shift, a Senate inquiry has been told.
"In many rural and remote communities ... people often rely on rotating workforces of local GPs, or they have no local GP at all," rural clinical psychologist Rebecca Gilchrist told the inquiry sitting in Albury, southern NSW, on Tuesday.
"Travel distances are quite significant, wait times are really long and the continuity of care is difficult to establish from the beginning.
"Telehealth is not just a convenience; it's often the only viable pathway to ... timely, appropriate care."
Ms Gilchrist, who treats people across remote Australia, said red tape was excluding already disadvantaged patients.
The consequences were significant, she said, giving an example of a vulnerable patient on a remote station repeatedly cancelling appointments because they could not get to a GP for a referral.
"I see delays in treatment, disengagement from care, and escalations in mental health conditions to the point of crisis, including avoidable emergency department presentations," she said.
The inquiry is examining the effect of the change, along with the financial sustainability of rural medical practices and any possible reforms.
Patients living in small towns may prefer to see a GP from another region via telehealth to ensure their privacy, Victoria-based clinical psychologist Olivia Clayton said.
"People have social or professional connections to their local GP and don't want to talk about mental health with someone they'll also see down at the footy field or at the local IGA," Ms Clayton told the inquiry.
Border Medical Association deputy secretary Lachlan McKeeman said the growing Albury-Wodonga region had lost many experienced GPs in the past three years.
While doctors did some training in rural areas, it was difficult to convince them to stay, Dr McKeeman said.
"It's a revolving door," he told the inquiry.
"When you've got them, you love them and you look after them as well as you can to try and convince them to stay.
"But the number that stay is just insufficient."
The inquiry will hold a hearing in Western Australia later in April.
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