No 205 March 2019

Mental health options

DIANA HARTE

Diana Harte is Senior Clinical Psychologist at the Ronald Sawers Haemophilia Centre, Alfred Health, Melbourne

Life is challenging and can be more so when living with a bleeding disorder.  Research tells us that one in five Australian’s between 16 and 85 years of age will experience a mental illness in any year.(1) People with a chronic physical condition are more likely to experience mental illness such as anxiety, depression and substance abuse.(2)  Yet over half the people who experience a mental illness do not access treatment.(3)   Now, everyone has times when they feel anxious, sad, ‘not quite right’ which can make it difficult to know when to seek help.  That first step is often the hardest…
 

WHEN TO SEEK HELP

 
It is important to seek help urgently:
 
  • When you are having suicidal thoughts (wanting to die) or are worried you might hurt yourself or someone else – services available are under More immediate options below.
  • If you are concerned that you or someone you know is at immediate risk of suicide or self-harm - dial triple zero (000).
 
Some signs that you may benefit from more specialist mental health support include:
 
  • If you have been feeling anxious, worried, sad, and/or “not quite right” and these feelings are not going away after several weeks
  • If you have noticed changes in your sleep and appetite/weight
  • If you are not doing the things you would normally do because you cannot be bothered or do not have the energy to do them including getting out of bed, having a shower, talking with friends
  • If you have been having emotional outbursts including anger
  • Friends and family have noticed that you are ‘different’
  • When your use of alcohol or other drugs is interfering with your health, relationships, school, and work.  Also, when you notice that you are needing use alcohol or other drugs to help you cope with your emotions or behaviour.  For example, you can only feel relaxed after several alcoholic drinks
  • Hearing or seeing things that no-one else can 
  • Spending more money, being more outlandish, making impulsive decisions
  • Believing that there are special connections between events 
 
If you want to check whether you may have been affected by depression or anxiety in the last month visit the Anxiety and Depression Checklist on the Beyond Blue website.
 
Your GP is an excellent starting point to seek help.  I would always encourage you to book a double or long consultation with your GP if you are wanting to raise concerns about your mental health.  If you are at school or university there are student health services.  If you are working, particularly for a large organisation, many now have employee assistance programs (EAP) that provide access to counselling.  And, of course, there is your Haemophilia Treatment Centre (HTC). The majority offer social work and some have psychologists on staff, and they will all also be able to refer you to other psychological support services.
 

TYPES OF HELP

There are however many forms of mental health support and treatment options; however, at times, particularly if you are struggling, it can be hard to know what is available.  A few are outlined below.

More immediate options

Lifeline – is for anyone having a personal crisis.  
T: 13 11 14 operates 24/7 
Or at night between 7pm and midnight you can chat online.
W: www.lifeline.org.au.
  
Kids Helpline – is for young people aged between 5 and 25 for any reason.  
T: 1800 55 1800 
Or webchat 
W: www.kidshelpline.com.au  
Both are available 24/7.

Suicide Call Back Service – if you are thinking about suicide, wishing you were dead, thinking how about you could end your life.  
This service is available 24/7 on T: 1300 659 467 
Or there is an online chat service as well as video chat 
W: www.suicidecallbackservice.org.au .
  
Beyond Blue – focuses on anxiety and depression.  
T: 1300 22 4636 24/7 
And between 3pm and 12 midnight you can chat online
W: www.beyondblue.org.au

At times people who have contacted telephone and internet support have told me that the wait has been too long so they hung up.  If you do need support please try to remember that there is someone who will take your call as soon as they can.  

Public mental health services 

Public mental health services are available in each state.  In general, public mental health services tend to provide ‘crisis’ services and treatment for acute, significant and serious mental health concerns.

Australian Capital Territory
Mental Health Crisis Team
T: 1800 629 354 or 
(02) 6205 1065
24-hour/7-days a week service, for assessment and treatment of mentally ill people in crisis situations
Further information can be found at: https://health.act.gov.au/services/mental-health 
New South Wales
Mental Health Line
T: 1800 011 511
24-hour telephone service, operating 7 days a week
Northern Territory
Mental Health Support
T: 1800 682 288
Free and confidential 24-hour hotline for mental health inquiries
Queensland
1300 MH Call   or 1300 642 255      Tele-triage service that delivers a single-point-of-access to public mental health services.  24-hour, 7-days-a-week service.  
Further information can be found at:  https://www.qld.gov.au/health/mental-health/help-lines/1300-mh-call
South Australia
Mental Health Services
T: 13 14 65
24-hours/7-days a week advice and information in a mental health emergency
Tasmania
Mental Health Helpline
T: 1800 332 388
Free statewide 24-hour/7-days a week service for mental health crisis reaching all regions
You can learn more about Tasmania’s mental health services at www.dhhs.tas.gov.au/mentalhealth/mhs_tas  
Victoria
You can find the contact details for your local service and learn more about the Victorian Public Mental Health Services at: www.health.vic.gov.au/mentalhealthservices.  
Nurse On Call
T: 1300 60 60 24
For immediate, expert health advice from a nurse.
Western Australia
Mental Health Emergency Response Line
T: (08) 9224 888
1300 555 788 (Metro) 
1800 676 822 (Peel)
Psychiatric emergency assessment and advice for mental health clients and their carers
Rural Link
T: 1800 552 022
Specialist after-hours mental health telephone service for rural communities
Mon-Fri: 4.30pm-8.30am, Saturday, Sunday, Public holidays: 24-hours.
It is my understanding if you ring the number during business hours your call will go through to your local mental health service
Further information can be found at: www.mhc.wa.gov.au/getting-help/public-mental-health-services

Structured internet-based treatment options

Mental Health Online: offers an online mental health assessment as well as a set of programs for specific anxiety disorders and depression. 
W: www.mentalhealthonline.org.au 

MoodGYM and e-couch: these are free self-help programs designed for use by adolescents and adults respectively. 
For adults - www.moodgym.anu.edu.au  
For adolescents – https://ecouch.anu.edu.au 

myCompass (Black Dog Institute): a free self-help program for people experiencing mild to moderate stress, depression and anxiety. 
W: www.mycompass.org.au 
 
OnTrack: offers several free self-help programs including one for problem drinking as well as support of family and friends who are supporting someone with a mental illness. 
W: www.ontrack.org.au
 
THISWAYUP: a set of self-help programs available in a desktop form or as an app with specific programs for particular disorders; there is even a chronic pain course.   You can access these courses independently, or if you are seeing a mental health clinician or doctor that is registered with THISWAY UP they can supervise your progress through the program.  Some of the courses do have a cost to access them.  
W: https://thiswayup.org.au
 

In person options

Your Haemophilia Treatment Centre (HTC) may be able to provide access to mental health assessment and treatment, as most have social workers and/or a psychologist on staff, or can refer you to a counsellor or psychologist. Once again, your GP is always a good starting point as they tend to know the availability of local public and private services.  Additionally, GPs can make a referral to a mental health clinician through Medicare.  One of the most common Medicare programs under which GPs make referrals to private mental health professionals is Better Access to Mental Health Care: this offers a rebate for up to ten sessions individual and/or ten group sessions in a calendar year.  To be eligible for Better Access to Mental Health Care you need to have a ‘clinically diagnosable’ mental illness.  At times when you are experiencing difficulties, your symptoms may not be at the level that allows a referral under Medicare.  However, it is always worth a discussion with your GP and it is recommended that you book a longer appointment with your GP for that conversation.  

You can learn more about the various different Medicare programs for Mental Health at www.psychology.org.au/for-the-public/Medicare-rebates-psychological-services.   

For those linking in rural and remote Australia there are now Medicare rebates for telehealth.  Some HTCs also offer telehealth under certain circumstances.
  
You do not need a referral to access a psychologist or counsellor, but there will be a cost to you.  Word-of-mouth is always a good guide as to the options in your local area.  Internet searches such as ‘mental health providers’ or ‘psychologist’ are good general terms. 

There are also professional bodies that list potential providers such as:

Australian Counselling Association 
T: 1300 784 333
W: www.theaca.net.au/find-registered-counsellor.php  

Australian Psychological Association 
T: 1800 333 497 
W: www.psychology.org.au/Find-a-Psychologist  

Australian Association of Social Workers
W: https://www.aasw.asn.au/find-a-social-worker/search/


Headspace
If you are aged 12 to 25 years, Headspace offers both face-to-face, online and telephone support with the majority of their services at no cost.  You can find out more at 
W: www.headspace.org.au

Internet versus in-person treatment

One of the major benefits of internet-based treatments, like those listed above, is the convenience.  You can do internet-based treatment anywhere you have an internet connection.  Another factor is cost: there are no travel expenses and as you can see from the above list there are many free options. Self-help/structured internet programs however may miss information that can be very important in accurate diagnosis such as facial expressions and tone of voice.  Also, at times it can be very difficult to maintain motivation to complete the program without someone to encourage you to do so.  In-person treatment offers that human connection and ability to adapt treatment to your specific needs.  Also, some very effective treatments are not suitable to be offered over the internet. 
 
The length and frequency of sessions required to address your mental health and emotional needs will depend on a broad range of factors including the severity of your symptoms, goals, and the type of treatment.  You will find that the majority of publicly-funded programs offer a limited number of sessions and at times people will require more.  The Better Access to Mental Health Care initiative program under Medicare only provides a rebate for ten sessions in a calendar year with an approved mental health clinician.

This can be incredibly concerning and frustrating for everyone; it is why using all available options such as internet-based programs and working with your mental health clinician prior to discharge on a wellness or relapse plan is so important.  

Insurance

An issue to be aware of, unfortunately, is that people who have or had a mental health diagnosis can have difficulties obtaining insurance.  If you do not disclose on insurance forms, even when applying for mortgage insurance, that you have sought emotional or mental health support it can void any policy.
 
You can learn more about this on the Beyond Blue website at www.beyondblue.org.au/about-us/about-our-work/discrimination-in-insurance.
 
There are many reasons as to why people who experience mental illness do not seek help.  At times it not understanding that what is being experienced is an illness and that there are effective treatments. On other occasions it is not being aware of the many options that are available. It can be incredibly hard to take that first step, and sometimes in that first step you do not find the ‘right’ person or service to support you, so you need to take a second step.  I do hope that this article makes taking a step to looking after your mental health a little easier.

References

1. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results, 4326.0, 2007. Canberra: ABS, 2009.
2. Slade, T, Johnston, A, Teesson, M, et al. The Mental Health of Australians 2. Report on the 2007 National Survey of Mental Health and Wellbeing. Canberra: Department of Health and Ageing, 2009.
3. Australian Institute of Health and Welfare. Australia’s Health 2014. Canberra: AIHW, 2014.

 

 
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Date last reviewed: 18 March 2019