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Navigating the mental health maze

When you need help with your mental health, it can be a bit confusing. Should you see a psychiatrist, a psychologist, a counsellor or someone else? Do you need to see your GP, and get a mental health treatment plan? Do you need to pay, and if so, how much? How long will you have to wait?

It can all be a bit too much to cope with, especially as this is most likely happening at a time when you're feeling stressed out.

So today we're trying to make that maze a little easier to navigate. And that's important because, if you set off on the wrong path you may:

  • Not receive the level of care you need, initially.

  • Waste time getting a referral you don't need.

  • Waste money in the wrong place.

It's also worth noting a few points as you navigate the maze:

  1. Counsellors, psychologists and psychiatrists are all mental health experts who are there to help you. Their roles do overlap to some degree, and you may end up with support from more than one of them.

  2. Most services will incur a fee, even with a mental health treatment plan. Generally, psychologists and psychiatrists will charge much more than counsellors, although with the mental health treatment plan the costs can be a bit closer.

  3. You may be eligible to receive a rebate from your private health insurance or to use your National Disability Insurance Scheme (NDIS) funding for these services, although you'll need to check that with the NDIS.

Mazes are never fun. They are, in fact, terrifying if you get lost in one, although maybe that was just me; I didn't starve, but I'll never walk into a hedge maze willingly again. And before we go through, it might help to use my favourite tool - a good analogy!

A (painful) trip to the gym

Imagine you've been going to the gym and you've had a problem. You're in pain, and you need help. But what's the right help to get?

If you were in pain but it didn't feel like something was broken or severely wrong you'd probably talk to either a physio or a personal trainer; it's likely that you're doing something that introduced that pain, and they will help you to find your way towards your goals with less pain and more 'gain'. Their job is to listen to you, work with you and help you gain the skills to get where you want to be.

If on the other hand you were in severe pain and felt something was wrong with your muscles or bones, you'd turn to the medical profession and see a GP, who might refer you to a chiropractor or other medical specialist to solve the issue. You might also see that physio or personal trainer to support that medical team, as your treatment progressed.

That's a simple analogy for your mental health; goal and wellbeing support? See a counsellor. Medical and more specialised support? See a psychologist or psychiatrist, with extra support from a counsellor if you need it.

So, should you start with your GP?

If you aren't sure what kind of help you are looking for, then yes you should start with your GP - and it's important to be aware of your options, just as with our gym analogy above. There are two paths here:

  1. Go straight to a counsellor (you don't need to see your GP first).

  2. Get a mental health treatment plan from your GP, and then go to a psychologist or psychiatrist.

A good GP will help you navigate this choice, and help you choose the right path for you. It's important that you are aware of the two options, and can bring to the table your own perspective on what your needs might be.

Everyone can find it hard to deal with life at times, we can all struggle with our mental health. We can get stressed out, anxious or depressed. We might feel that way for a few hours, a few weeks or a few months - this is part of being human. Think of this as being mentally 'unwell'. When this is the case you might need a counsellor more than a psychologist, since a counsellor is trained to help people by listening to them and helping them to achieve their own goals within their life - in general, but also specifically around their emotions and mental health.

Then, there is mental illness. Around 700,000 Australians live with a mental illness, a condition that significantly impacts how they feel, think, and/or behave. Mental illness requires a diagnosis and has symptoms and impacts. This requires seeing a psychologist or psychiatrist.

Mental illnesses include conditions such as schizophrenia, bipolar disorder, personality disorders and more. They also include anxiety disorders and clinical depression - which is a more severe and persistent form of depression.

If you have been diagnosed with, or suspect you have a mental illness, then you should start with your GP who will confirm if you should see a psychologist or psychiatrist. You should work with your GP to get a mental health treatment plan.

Pathway 1: straight to a counsellor

If you're concerned about your mental well-being but don't suspect you have a mental illness, then you can look for a counsellor. And if they believe you need more support than they can provide, they'll help refer you from there.

You do not need a mental health treatment plan and don't need to see your GP first, you can simply select a counsellor and book in straight away. And the process is simple:

  1. Identify the counsellor you think will be best for you.

  2. Call them, and ensure you really are a good fit.

  3. Book in, and pay.

Counsellors are usually available on relatively short notice and can work online, in your home or in an outside location (such as with our walk and talk therapy). You shouldn't need to wait long to see one and will pay around $100-150 per session.

Remember, you're always in control of your counselling; you start when you want, you choose who you want, and you stop when you want.

Pathway 2: Psychologist or psychiatrist

There are many similarities between counsellors and psychologists/psychiatrists - they are all there to help and support you with your mental health. They are all able to use their expert knowledge to help you understand yourself better, and use counselling approaches and skills to assist you.

But there are also some important differences. Psychologists and psychiatrists are focused on diagnosing and treating mental health illnesses, as their core approach to support you.

Psychiatrists are medically trained and can prescribe medicines for mental health conditions if needed.

You should start by seeing your GP who may well tell you whether to see a psychiatrist or psychologist. They will usually require a referral to see you, and will usually either see you in their rooms or online. Although you may need to return to your GP a few times, you can receive up to 20 sessions per year on a mental health treatment plan. So the process should be:

  1. See your GP first, and get a mental health treatment plan, trying to confirm if you should see a psychiatrist or psychologist.

  2. Call them, and find out what the waiting times and out-of-pocket expenses are.

  3. Book in, and pay.

Costs will absolutely vary between them, and you will normally have to pay the gap fee. For example, puts the current recommended cost of a single psychology session at $280, our experience shows the costs range from $250 to $300 or so. Medicare will rebate you between $84 and $124 for the session depending on the type of psychologist you see, so potentially it will cost you between $125-175 per session in out-of-pocket expenses. That is only a guide, and you'll find you may receive free or discounted services from some psychologists.

The psychiatrist or psychologist may still refer you to a counsellor as well. Counsellors provide that day-to-day support that you may need - and whilst this is something that psychologists and psychiatrists can also do, they are sometimes too booked out to enable this on a regular basis. A counsellor can see you several times a week if that's what you need.

I can't afford to pay anything - what are my options?

Unfortunately, this does make things a little harder, but there are still options available.

  1. Use free mental health services There are free mental health services available in Australia, such as those available from Griefline, Lifeline, BeyondBlue and many more. They aren't always available in every location or exactly when you need them, but the fact that they are free can really help. They can be limited, and hard to find, but they are there.

  2. Look for bulk-billing psychologists They can be hard to find, but there are some out there. If you have received a mental health treatment plan from your GP and if you can find one and get onto their waiting lists, this can be an option.

The final word

It's important to get the right help, and if possible start off on the right path. But if you find you've made the wrong choice, your mental health professional - whether that's a counsellor, social worker, psychologist or psychiatrist - will help guide you towards the right level of help for you.

It's also important to remember that these levels of help are not mutually exclusive; a counsellor can work with you on day-to-day support whilst a psychiatrist or psychologist supports your longer-term mental illness.

I hope this helps make the maze a little easier to navigate - but if you're not sure, please feel free to contact me and ask. I'd be more than happy to help.

In the meantime, take care of yourselves, and each other.


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