Awareness over mental health being an illness and strategies for one’s mental health has become increasingly common. There are often slogans thrown around like “reach out for hell”, and programs like R U OK Day are implemented at schools and universities all over the country. But what happens when you finally reach out for help, and find you have to wait for months to even get your foot in the door?
Like most people, I have struggled with mental health issues, especially in the wake of COVID. To get the support I needed I had to pay exorbitant fees and join long waiting lists — it took me a year to see a psychiatrist for ADHD medication. This led to large periods of time where I felt I did not have access to the help I desperately wanted and was a big financial strain.
Australia’s mental health system is financially destructive and completely inadequate at providing patients with the services they need. In the wake of the increased feelings of depression, anxiety and isolation people were feeling during the pandemic, the increased demand for mental health services revealed how broken it is. Programs like R U OK Day and awareness months allow the government to ignore the structural failures that lead to the deterioration of individuals mental health and the insufficient avenues people have to improve it.
The Australian psychological society’s healthcare index survey shows the severe pressure the mental health sector is under since the pandemic. Almost two thirds of patients had to wait more than 12 weeks to receive care. 1 in 3 (33%) psychologists are unable to see new clients due to heightened demand, an increase from 1 in 5 (22%) from June 2021.
The high barrier these wait times create has created a group of people whose issues are too complex for a GP but are not severe enough for hospitalisation who are left to handle mental health issues with little support. The Victorian royal commission identified this issue, calling Australia’s mental health system “crisis-driven”, too reliant on medication and hospitals designed to treat people rather than support the majority with day to day mental illnesses.
Psychologists have been warning about the increasing barriers to care for a while, with the inability of the psychology workforce to respond to demand. 25% of psychologists are 55 years old or older, the largest workforce shortfall of any mental health profession and the federal government is only meeting 35% of its workforce target for psychology.
There is simply not enough government support to help train new psychologists and psychiatrists or to encourage people into the field, meaning that it is unlikely we will have enough professionals to support demand in future. The National Association of Practising Psychiatrists have spoken about the limited training opportunities that exist for new psychiatrists which exacerbate this shortage. Professor Phillip Morris argues that “While a major investment of public resources is required to deal with the mental health crisis, the money will not be well spent unless issues of accountability, service direction and training are addressed.”
Even if you do manage to find a psychologist or a psychiatrist with a reasonable waiting list, for many people it is unlikely they can afford it. Most patients when seeing a psychologist/psychiatrist will first seek out a Mental Health Treatment Plan. A Mental Health plan is a form you can receive from your GP after they diagnose you with a mental illness to help cover the costs of appointments; you can receive up to 10 individual sessions in a year. While this number of sessions can sometimes be enough for people dealing with issues like mild anxiety or periods of grief, 10 issues is nowhere near enough for people dealing with complex traumas or those with more serious mental health issues. This means that people with the most serious mental health issues have to be financially comfortable to be able to receive necessary help. Melbourne mother Laura Strehlau says that the extra 10 sessions the government offered during the pandemic “saved her life” when she was struggling with the worst of her bipolar disorder. The government fails to consider what is the most effective treatment for people suffering from different issues.
Some psychologists provide bulk-billing services, meaning that you don’t have to pay for any of your medical services from a health professional as Medicare will offer them a rebate. This leads to no out of pocket costs for patients, but few professionals offer this as it’s extremely unsustainable. Some bulk-billing psychologists will earn on average $12-$20 an hour, below minimum wage. While this is obviously an unsustainably low salary, many patients can’t afford increasingly high Gap Payments (a gap payment is the difference between what a doctor charges you and how much medicare will give you back). The government’s continued severe lack of funding to the health sector has meant that many people are just financially locked out from receiving help and that psychologists who do offer services like bulk-billing will be underpaid.
The deterioration of Australia’s mental health services is only one part of the hollowing out of our state institutions, but there is some hope for the future. The Victorian government had committed $3.8 billion dollars to the mental health care sector over the next four years, overspending the federal government by 65%, setting an example for the rest of the country. Victorian Treasurer Tim Pallas has said that this funding would overhaul the stressed Victorian mental health system and would implement the 65 recommendations of the state’s royal commission into mental health.
“I think any government that prides itself on prioritising the welfare and the wellbeing of its population and that supports the idea of a growing economy could look no further than the state of Victoria for runs on the board,” said Pallas.
While a review of the Medicare system is a good start, professionals are worried as there is little concrete evidence about how it will help those struggling to see doctors, or how much costs and wait times aim to be reduced. Without governments the necessary action to change our health system, it is unlikely we will be reformed to be able to adequately support the most vulnerable with their mental health any time soon.