Video psychiatry consultations rose more than fivefold in Australia as provision dispersed

Video consultations with psychiatrists have risen from a marginal option to a substantial share of Australian mental health care, according to a postcode-level data-linkage analysis published in BMC Psychiatry. Drawing on what the researchers describe as the largest database of psychiatric consultations in Australia — 13.5 million Medicare Benefits Schedule consultation records spanning 2017 to 2023, linked with 2021 Census data — the study tracks how telepsychiatry use shifted across successive telehealth policy periods. In 2017, video consultations accounted for just 5 percent of all psychiatric contacts recorded in the dataset.

That share climbed sharply to 23 percent in 2020, the year pandemic-era telehealth rules reshaped remote care, and continued rising to 28 percent in 2023. The analysis, conducted by Luke Sy-Cherng Woon, Jeffrey C. L. Looi and Wai-Man Liu, indicates that video consulting has become an established mode of psychiatric service delivery rather than a temporary pandemic workaround. The team computed monthly and yearly fractions of face-to-face, video and telephone consultations for each provider postcode, then measured how concentrated each mode of provision was using the Herfindahl-Hirschman Index, a standard gauge of concentration.

For video consultations, the index more than halved, falling from 0.026 to 0.011, which the authors interpret as a marked geographic dispersion of service provision across the country. To identify the factors associated with video mode choice, the researchers ran fractional logit regression models on the postcode-level video consultation fractions. The results revealed a consistent sociodemographic pattern.

Video use was more common among metropolitan clinicians and among practices serving higher proportions of female patients. It was less common when patients were older or lived in more socioeconomically advantaged areas — a finding the authors flag as a persistent gradient that runs counter to the assumption that telehealth primarily benefits the affluent. During the consolidation phase of telehealth policy implementation, remote and regional providers increased their services to metropolitan patients by 450 to 783 percent.

That surge indicates that rural and regional psychiatrists were not merely serving local patients over video, but were increasingly drawing patients from major cities. The authors conclude that telehealth-enabling policies are associated with a sustained and more geographically diverse provision of psychiatric care, with participation expanding among both urban and rural providers. At the same time, they caution that the persistent sociodemographic gradients in their data highlight the need for targeted policy and service planning to secure equitable access as telepsychiatry matures into a routine mode of care.

As an observational, postcode-level analysis of billing records, the study describes patterns of utilisation and association rather than establishing causal effects of specific policies, and its ecological design means findings at the postcode level may not capture individual patient circumstances. Nevertheless, the scale of the linked dataset — 13.5 million consultations across seven years — gives an unusually detailed picture of how Australian psychiatry adapted to telehealth reform, and of who remains on the margins of that transition.

Subject of Research: Postcode-level data-linkage analysis of Medicare-reimbursed video telepsychiatry utilisation and associated factors in Australia, 2017–2023

Article Title: Provision of Australian medicare-reimbursed video telepsychiatry services: a postcode-level data-linkage analysis

Article References: Woon, L. S.-C., Looi, J. C. L., & Liu, W.-M. (2026). Provision of Australian medicare-reimbursed video telepsychiatry services: a postcode-level data-linkage analysis. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08784-6

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08784-6

Keywords: telepsychiatry, telehealth, Medicare, Australia, data linkage, health policy, geographic access, psychiatry, health equity, video consultations, BMC Psychiatry, Provision