Data from The Banyans Healthcare Group reveals enquiries for anxiety, PTSD and bipolar have increased by over 100%, showing a staggering 102% increase in people seeking help for issues with anxiety.
45% of people will experience a mental health condition in their lifetime and there are approximately 3 million Australians currently living with anxiety and depression. These conditions are widespread and do not discriminate and affect Australians of all ages.
Following on from Dr Kennedy’s excellent Saving Brothers article which described how people can recognise when they may need help, I wanted to provide some guidance on where that help can be found when they need it.
COVID-19’s impact on mental health
The changes relating to COVID-19 in the last two years have had an impact on all of us to some degree. As a GP I have always been aware of how often mental illness symptoms were present in patients asking for help, even if their chief complaint was apparently physical, but recently I have noticed an increase in requests for help for mental health problems specifically.
This trend is both worrying and reassuring at the same time; worrying since it highlights a growing number of people that are struggling and suffering out there, but also reassuring since I’ve seen a shift in demographic groups openly seeking help more readily than they did in the past. For example, young males and people who are Culturally and Linguistically Diverse (CaLD), suggesting that the stigma against mental illness and seeking help is reducing.
How to get subsidised mental health services?
Historically, mental health problems may not have been openly recognised or validated, which did lead to poorer care and treatments in many cases. But also, historically people may have had access to an extended community support which may not be the case nowadays. Previously people tended to live in smaller communities, alongside or close to extended family and would often have support from community organisations and services. That extended family and community support structure is less prevalent in our modern 21st century world and it is well recognised that having hundreds of ‘friends’ on social media does not equate to feeling more supported or part of the community – probably quite the opposite.
Thankfully there are many places for people to seek support if they’re struggling, such as Saving Brothers, and also Beyond Blue, Black Dog Institute and Lifeline.
One place to get help that has persisted over the decades remains the family doctor, or GP. All GPs receive training in recognising, diagnosing, supporting, treating and, where necessary, referring patients to other services for mental health conditions. I am a great believer in General Practice remaining a first port of call for any health need and there is evidence worldwide that people with a regular family doctor do better in the long term.
Some GPs, like myself, have completed further training to deliver talking therapies to patients, called Focused Psychological Strategies, which can help people using techniques similar to those utilised by psychologists, for example Cognitive Behavioural Therapy (CBT). However, whilst not every GP has the time or training to use these tools themselves, all GPs are available to refer eligible patients to a trained psychologist, and Medicare provides subsidies to patients to support that treatment financially.
How do I get a referral to a psychologist?
Although it is ideal to see a GP that you already know, any GP can help you with this. However, to offer that help appropriately we often require more time than a standard consultation would allow us. I encourage my patients to book for a 30-minute appointment if they are seeking a mental health referral and I’d strongly encourage that as a patient you do this proactively too. In order to attract the Medicare benefits for treatment with a psychologist, GPs must prepare what is called a GP Mental Health Care Plan.
The GP Mental Health Care Plan
This care plan is really a summary of what things you are struggling with, what the GP believes might be the cause, some assessments of your symptoms which should include a questionnaire measuring your symptoms such as a K10 or DASS21 form, and the most important aspect in my opinion – goal setting of what you would like to achieve with the therapist.
Although reducing unpleasant symptoms would seem to be an obvious goal for most people, psychologically we know that behavioural goals tailored to the patient are more useful and more achievable. For a patient suffering from depression a goal of “no longer feeling depressed” may seem simple enough, however, a tailored goal to improve that patient’s life overall might not only be more achievable but include some subtle yet important changes in their approach to their difficulties and therefore become part of the treatment itself.
A specific behaviour goal might look something like, “Learn some skills to handle my depressed feelings and thoughts better so that I can return to work and improve my relationship with my family”.
Once the care plan has been completed with you, you should be offered a copy, and a copy is also included in your referral to a registered psychologist. You may have the name of a psychologist in mind, or your GP might be able to recommend someone. Once this is in place, any treatments offered by the psychologist would then attract a Medicare rebate, the same as when you see a doctor. Nowadays this can be face-to-face or via Telehealth.
Traditionally Medicare would subsidise 10 sessions every calendar year, but since COVID, the Federal Government has increased this to 20 sessions and there are no current plans to reduce this.
Mental health problems are common but you are not alone. There is a whole network of people out there ready to support you.
Dr Matt Warburton is a Medical Doctor and General Practitioner with interest in mental health. He is endorsed to provide Focused Psychological Strategies following training he has completed with the Royal College of GPs here in Australia. He works at The Banyans Medical Centre in Bowen Hills, Brisbane.