The Mental Health System Struggle & Advice needed

Hey there

I think after you spend a certain amount out of pocket Medicare begins rebating private psychiatry or psychology sessions and you get approx 80 percent of each session covered by Medicare.

So if you see the psychiatrists as you said you prefer weekly, after two months or so the sessions will decrease in our of pocket expense. Forgive me if my maths is bad. This is called the threshold and the threshold is lower for people who are on healthcare cards.

Psychiatrists vary a lot in price and some do offer discounts if you are not working ft or are on a centrelink payment

I also advised someone here that to become a practising psychiatrist the psychs often train as psych registrars junior psychiatrists . Then they graduate and become consultant psychiatrists.

When they make that next step they will be new to practise and not have a lot of patients yet, so if you call a practise and check if they have any new drs or newly practising drs perhaps those will have space to take on new clients. I don't think jnr is bad in these situations because recently trained means up to date with more current info and often newer doctors have good energy and enthusiasm about their role. Definitely not all but my dr is young and new to practise and I've had a great experience

Thank for your advice unfortunately I do not have a concession or am I on centrelink payments so unfortunately I’m slogged with the whole fee or a very small rebate back from Medicare of a large $360+ fee if I get a new mental health care plan which a new dr won’t do which is also causing problems given my current dr is unable to do this atm.

Sadly, the reality is I can’t afford $360 a month let alone a week or fortnightly even with the tiny rebate.

I'm hesitant to go down the path of jnr psychs as I have a very complex set of mental health Illnesses. I suffer from bipolar II disorder, borderline personality disorder with a comorbidity of generalised anxiety disorder and social anxiety disorder. And from what I’ve been previously advised that is far too complex for jnrs and in the realm of a senior psychiatrist.

the system really isn’t working as it is and I hope in time changes are made. When I first saw a psychiatrist for intense psychotherapy for years it was completely bulk billed and saved my life.
I fear for those without that option now.

Hi @Romy80 , welcome

I can empathise. I have 6 MIs (mental illnesses) and my GP of 35 years retired last year, which really threw me. It took me most of a year but now I've found a good local new GP.

I've also had a great psychiatrist who did talk therapy retire, and ended up finding a new psychiatrist who is OK. But the best thing is I found an excellent psychologist who was even better.

Regarding the bulk billing, as I understand it no psychiatrists bulk bill any more, or GPs either. I actually have never heard of seeing a psychiatrist weekly or fortnightly bulk-billed, and consider that you have been extremely and incredibly lucky. It's just not a reality any more.

I really hope you can get a new MHCP, then at least you can get 10 subsidised sessions a year.

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@Romy80 wrote:

My fears of abandonment and being unable to control the situation are extremely overwhelming.

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I am sorry to hear 😞

Do you think this might help?

- Find a psychiatrist

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Hi @Romy80

I was reading the comment by @NatureLover and it got me thinking about your practitioners. I don't know how any of this stuff works for anyone else but I would think seeing a psychiatrist every 1-2 weeks is excessive. In my experience you would see a psych nurse to talk about issues every few weeks, then a psychiatrist every 3 months or so as all they really do is monitor medications from the psych nurse reports. If meds are stable then why see a psychiatrist every 2 weeks? And you mentioned your GP prescribes your meds? Again, isn't that the job of a psychiatrist? I thought a GP should be part of a treatment plan but I didn't think they did the job of a psychiatrist. If your GP is prescribing meds what is the psychiatrist for? Could his/her role be handled by a therapist? Sorry if mods have a problem with this but it would be nice for this person to get some professional guidance over this, it all seems excessively complicated and confusing. Is there any advocacy for this sort of thing? In my case I have been forced to learn some of this stuff as I have had so many (unnecessary) problems in the past. We as patients shouldn't have to fix the failings of our own treatment. Again, as @NatureLover says, maybe it's time to get a new mental health plan from your new GP?

hi @Romy80, not sure I have advice besides what's been given, but I know a lot of us struggle to pay MH support (which is so unfair). For me, my psychiatrist is also super expensive, but I only see them occasionally.

If I understand correctly, you get talk therapy from your psychiatrist? Would you be open to other kinds of therapists for your talk therapy?

At SANE, we have a free, guided service. We're only big enough to work with a handful or postcodes, but you could call our drop-in line to see if you're eligible or to find talk through some other options.

• You can read more about the guided service here
• And either call, email or use the webchat for the drop-in service here

What do you think?

Hey Romy even if you aren't on cenrelink you still get the 80 percent of the fee back, it just takes a bit longer because the threshold is a bit higher think approx 2000 out of pocket approx. But after that, your sessions will be rebated for 80 percent, for everyone. Just if ur on the health care card cover it is less out of pocket before the discount hits.

It is pricey though and unfair until then. I hear you.

Hey @Romy80 it is high, I think approx 2500 out of pocket....eek.

https://www.servicesaustralia.gov.au/what-are-medicare-safety-nets-thresholds?context=22001

Not sure how people afford this. I agree that psychotherapy weekly is life saving or can be for some. I see a psychiatrist weekly. He lowered the fee for me. I just mean that sometimes young or new drs have more wishom than we think if they "get it" but that's very individual. You are right to follow your gut !

Im sorry you lost access to ur bulk billing psych. I hear U.