• Julie E Byles, Xenia Dolja-Gore, Deborah J Loxton, Lynne Parkinson, and Jennifer A Stewart Williams.
• Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW, Australia. julie.byles@newcastle.edu.au
• Med. J. Aust. 2011 Feb 21; 194 (4): 175-9.

ObjectiveTo quantify women's uptake of Medicare Benefits Schedule mental health items, compare characteristics of women by mental health service use, and investigate the impact on Medicare costs.Design, Setting And ParticipantsAnalysis of linked survey data and Medicare records (November 2006 - December 2007) of 14 911 consenting participants of the Australian Longitudinal Study on Women's Health (ALSWH) across three birth cohorts (1921-1926 ["older cohort"], 1946-1951 ["mid-age cohort"], and 1973-1978 ["younger cohort"]).Main Outcome MeasuresUptake of mental health items; 36-Item Short Form Health Survey (SF-36) Mental Health Index scores from ALSWH surveys; and patient (out-of-pocket) and benefit (government) costs from Medicare data.ResultsA large proportion of women who reported mental health problems made no mental health claims (on the most recent survey, 88%, 90% and 99% of the younger, mid-age and older cohorts, respectively). Socioeconomically disadvantaged women were less likely to use the services. SF-36 Mental Health Index scores among women in the younger and mid-age cohorts were lowest for women who had accessed mental health items or self-reported a recent mental health condition. Mental health items are associated with higher costs to women and government.ConclusionAlthough there has been rapid uptake of mental health items, uptake by women with mental health needs is low and there is potential socioeconomic inequity.

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