The Mental Health System in Australia Is F*cked.
Around the world one person takes their life every 45 seconds, can you believe that? By the time you've scrolled a couple of posts, one person has killed themselves.
Yesterday, the 10th of September was World Suicide Prevention Day. I could have posted the warning signs that someone is going to commit suicide, but sometimes there is none. I could have posted tips on what you should do if you think someone is going to kill themselves, but sometimes they've already set their mind on it and there isn't anything you can do at that point. What I can do, is educate you on the current situation, which I believe if we began to rectify, we could start preventing suicide and bring that number down.
In Australia, 8.6 Australians die every day by sucide, that is more than double the road toll. But how many more advertisements do you see about safety on the roads compared to advertisements about mental health. It is the leading cause of death in our country and yet we barely hear about it. Let’s just pretend that Australia is not living in a mental health crisis.
An inquiry recently revelaed that approximately half of people who had died by suicide had actually presented for help in their final six weeks. They want the help, but the system is BROKEN, the system is failing people who desperately need them.
People being stuck in the middle- their issues are too serious for one service but not serious enough for another, they’re stuck in limbo. Young people with self harm or suicide related beviours being dischared with little to no follow up to check on their mental health, treat the physical and ignore the mental.
Time to make mental health support more accessible.
An estimated 5.2 million Australias have a mental or behavioural condition, to deal with this there are only 161 public hospitals and 68 private hospitals in the country that have specialised mental health services for admitted patients.
More than 60% of people who are seeking mental health support have a three month wait AT LEAST in front of them. If you’re waiting for a bulk billed appointment it could be even longer.
With the cost of living increasing at a rapid rate, there are more and more people who need to wait for a bulk billed option. For many, paying outright, or for a private psychologist is not feasible, they have no other choice. Wait lists continue to grow, people continue to suffer.
“Our mental health is just as important as our physical health, but it isn’t always treated that way. Physical health is often where we put the money- be it rural incentives, bulk billing incentives. It happens in medicine and nursing but it needs to be extended to psychology as well.”
The price you pay for your mental health services largely depends on the treatment that you need. A private psychologist sets their own fees, but the recommendation is that a 46-60 minute consultation should be $280, but this is just their recommendation, there is nothing to enforce that. Some practitioners charge as low as $150 per hour (and you can bet these ones are fully booked out) but there are others that will charge as much as $400.
If you are able to claim a consult on Medicare you might be lucky to get $130 back, until the end of 2022 that will work for 20 sessions, after that it will most likely go back down to 10. To get these sessions you must be referred by GP, which is an extra cost. This cost may be more than a standard appointment when you need to create a mental health plan with your GP. They usually ask you to make a longer appointment.
Seeing a psychiatrist is even more expensive.
For a little context: this year I changed psychiatrists, this is what I pay for this service. My initial consultation was $550, I received $237 back from Medicare. I have had a 15 minute phone consultation with her as well, this cost me $220 and I got $78 back from that one. I have a half an hour, in person appointment scheduled this week, I’ll keep you updated on that one. In addition to this I also had a private ADHD assessment with a registered psychologist, this is not covered by Medicare. I was out of pocket $1050 for that.
Private heath care insurance is pretty useless here too, it only covers you for hospital admissions. Appointments with a private psychiatrist (outside of a hospital stay) are not covered (the same for all private specialists).
What about medication to treat mental illness? For 150mg of my anti-depressant I pay $32 for 100mg and $23 for 50mg, this lasts me a month. For my ADHD medication I pay $35, this also lasts one month. For my mood stabilisers I pay $17, again for one month. This equals $107.00 per month for medications. While I can afford this, people on lower wages, people who are struggling with money probably cannot.
How many psychologists do we have?
The short answer: not enough.
The long answer: Recently, the Australian Psychological Society has began a campaign for the health department to put in place some encouragement for people to head into the psychology sector. Currently, a Masters in Psychology costs anywhere from $32,000 to $50,400 but the society is calling for the Health Department to offer this course for free, or to be subsidised to get more students in.
Mark Butler, who is the Federal Health Minister, would not commit to any such action and instead opted to blame the Morrison Governement for the shortage. Understandably, the APS are disappointed that similar scholarships were able to be offered for nursing degrees but not for this. “Offering scholarships could be the difference between whether someone could access a psychologist or not.” ASP President Tamara Cavenett told The Oz.
While it costs a lot of money to get your Masters in Psychology, there is also a lack of places available for people to continue their studies. According to Cavenett there was one Victorian University who was only able to offer 21 positions in their masters program, for which they had 700 applications. Universities don’t make as much profit from a Masters of Psychology and instead must put their money in other, more profitable places- hence why government help is much needed.
So, we don’t have enough professionals to deal with our mental health crisis, but the ones we do have might not even be able to help you.
More than 30% of Australian psychologists are not able to accept new patients. Just a couple of months ago myself and my doctor rang around to find me a new psych- we called five before we found one that had availability in their books, and it had to be private. In 2021 there was 10,716 registered, clinical psychologists in Australia. That is almost 500 people struggling with their mental health to each psycologist. No wonder they need to close their books.
What about if you don’t live in a metro area?
People who live in rural areas are two times more likely to die by suicide, so what do we get? A whole lot of nothing.
There has been a rise in access to Telehealth appointments, but they come with their downsides. Firstly, a physical exam cannot be assessed, can you see that your patient has lost a dramtic amount of weight? Can you see the self harm on their body? What about the fact that some people don’t have access to reliable internet service- in rural areas the reception is still terrible in 2022, you might have the best internet package but it doesn’t mean its always working. In addition, people may be reluctant to share their personal data over the internet. Some people, they just want in-person appointments.
When you live rural it is not just a quick hour to see someone for an appointment. It is AT LEAST a whole day trip. You need to get there, have your appointment and then get home. For some people, it is better to get a whole lot of appointments done in one go, this might mean staying for a couple of days. For this you need to factor in family commitments, work commitments, money stresses, what if you don’t have a car to get there?- it is no simple thing.
According to research up to 135 people are affected when someone commits suicide. Not only are we losing people, other people are hurting. We’re suffering. Australia is in the midst of a mental health crisis and more needs to be done.
