I am about to enter the world of privately funded mental health care. Up to now I have been incredibly lucky to have access to excellent psychological care through the public hospital system. This came about through my hospital stay last year, at which time I was referred to a psychiatrist when I was in the hospital and at the end of my stay it was determined that for my ongoing care I needed ongoing psychological care.
From all that I can tell through my notes I had a great relationship with the psychologist I saw, she left back in February this year and I saw another clinical psychologist at the hospital. She has now also left. Over that time I had 56 sessions so approximately weekly for a bit over the last year, in addition I had access to phone support whenever needed. Honestly, I am not sure I would have gotten through the last 12 months without the access to that care.
Yesterday, we trotted off to my GP to get a Mental Health Care Plan. It entitles me to 6 initial sessions and then after a review an additional 4 sessions (so a total of 10) in the next 12 months. This sounds great except I just told you that in the last 12 months I have basically had weekly sessions. So how do I make 10 sessions stretch out over 52 weeks. Ten sessions isn’t even one per month! But this is it. Well after a lot of reading this morning for this post there is a potential somewhere for an extended plan but this requires a change in diagnosis from what I can tell and I cannot find any information on how many more sessions that would actually give me or anyone.
For the moment I am also lucky that the psychiatrist I see is the one I saw when I was in hospital so can also see him through the hospital. This means that there is no direct charge to me. However, like with my psychologist this is obviously subject to change at any time.
I had a really ordinary night’s sleep which in itself is not a big deal but I am certain it has to do with all the changes at the moment. In addition to this we have an election coming up and Health Care in general is front and foremost with lots of discussions, promises and possibly even empty promises around Health Care. This leaves me wondering where and what are the policies around Mental Health Care.
What I have discovered is that Mental Illness with over 4 million diagnosed (and who knows how many living with it undiagnosed) is the third largest chronic illness in Australia behind only cardiovascular disease and diabetes. In 2012, the death toll from suicide related deaths was double that of the national road toll! How is this not a national emergency? Why are we as a society not doing more about it?
In 2015 a report was handed down to the government by the Mental Health Commission that recommends a complete overhaul of the system. There are lots of interesting facts and figures thrown around in the summary that I read. Honestly, my eyes glazed over a bit and I got angry a lot. I don’t mind reading reports about a lot of things but this just made me angry.
There is a lot of information about the economic drain that mental health is on the budget which I completely accept but I can’t help wondering if this is a result of it going so under funded for such a long time that it is at crisis point now. I accept that there needs to be a re-think about how mental illness is addressed as a society and funded from government but I am not sure I understand how these recommendations will help. Apparently we need to a patient centred model (I would like to think that is the case as it is now) and we need to reduce the reliance on the government to solve the problem is the summation. “The first priority of a person-centred system is to enable individuals and their families to look after themselves. For most people, self-care and support from those closest to them are the most important resources they have to build and sustain good mental health and overall wellbeing, from birth until death.” The report uses a lot of catch phrases and possibly could work if everything is implemented at the same time and wholly embraced. I am yet to ever see that happen.
This sounds really nice. I just can’t see how this will happen with current system. I saw an article my cousin posted about the reduction in funding to Headspace this morning. The Health Minister argues that they are reducing funding to specific organisations and giving it to overarching Health Networks so individual Headspace centres “could possibly” end up with more money. But what happens to the ones that don’t? This prompted me to investigate the election policies of the two major parties. Honestly they both leave me wondering. There are lots of words but no actual substance that I can see they are both making lots of promises to take the problem of Mental Health but I want to see how. I want the details.
Here is a real life scenario:
Family with 2 children. Mother working full-time annual income around 75k. Father not working due to ongoing chronic mental illness. Not eligible for DSP or Health Care Card as family income is too high, receives an extra approx 13k in Family Payments.
Total annual income approx 88k before tax
Medication 4 scripts per/mth 1500
Psychology 10 sessions free
16 sessions 1600
Psychiatry 6 sessions 2700
Minimum cost 4630 in a year
All of these assumptions are based upon that the condition stays stable and there are no acute episodes and no extra sessions are required or hospital care. This also doesn’t factor in the Private Health Insurance costs of the family. The private health insurance that will only partially cover a stay in a private hospital if needed so there can be huge out of pocket gaps. This also doesn’t factor in the cost of the GP visits that add up as well.
This situation isn’t uncommon, I would argue that the financial stress of illness contributes to the illness itself.
I am not a fan of pointing out all the problems in a system without coming up with some solutions. I will be honest and say that the situation is complex and there is absolutely no simple solution.
The government is concerned about rising costs understandably. The government is concerned about the economic costs to society of the Mentally Ill not being able to financially contribute or be “productive” members of society, they are leaners and not lifters. They are tax burdens instead of tax payers except that they aren’t they pay tax on everything they do & buy by way of GST so everybody regardless of income is a tax payer. There is no way to avoid GST in day to day life.
I wonder if a barrier to accessing the support required is the cost. This then leads things to get to a crisis situation. I wonder if the blowout in costs in recent times is as a result of the underfunding over a very long period of time. I know how hard it is to reach out and say I am not doing ok and I need help. It would be even harder to reach out and then find out that you also can’t afford the help that you need.
Perhaps an answer would be to make Psychologists Primary Health Carers like GPs and Optometrists. I wish I had an answer. What I know from reading is that I don’t have a lot of hope for the future for people with mental health if we are relying on the government or the opposition to fix the funding. I guess the answer is just don’t be poor and sick!
I have included a raft of links for you to read to make your own decisions:
Daily Telegraph Can We Talk 20 June 2016
Australian Liberal Party (harder to find not listed in 2016 Election Policies here)
National Mental Health Commission Contributing lives, Thriving communities Nov 2014
I know that Mental Health is not sexy. I also know that with at least 4 million people living with a mental illness in the community everyone will know someone dealing with this in their lives. So if it doesn’t matter to you it will matter to them. While you are checking out Mental Health make sure you look at the long term health policies and remember Medicare is not free government health care we the taxpayers fund this through the Medicare levy.
Thanks for reading my very unsexy waffle! And the answer to the question is it matters because lives matter, because people matter and a well funded health care and mental health care system will ensure that our economy does grow. The more “well” our society is the better chance there is that people can look after themselves instead of relying on the government to look after them.