Tag: Medicare

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Opinion/Commentary

Rent or therapy: the choice Australians shouldn’t have to make

Human hands unraveling red threads on human head, representing the human brain
Image: Ildar Abulkhanov, iStock

This is horrible.

According to the Sydney Morning Herald, provisional psychologist, Emily Radford has clients that have to choose between paying for therapy or paying rent. Radford is a National Disability Insurance Scheme (NDIS) provider. However, they have clients that pay out of pocket.

Radford offers same services to both sets of clients:

Radford’s rate is A$156.00 a session. Provisional psychologists aren’t covered under Medicare. Meaning, clients have to pay full fee unless they have private insurance.

Psychologists push for reform

Cropped shot of psychologist with a long sleeved blue shirt taking notes and talking to client
Image: PeopleImages, iStock

Psychologists are pushing for reform. Two psychological bodies are pushing the Labor Government to allow provisional psychologists to be covered under Medicare. This will increase the workforce by 8,000.

However, many argue that this will further burden the Medicare system. Instead, the Government should invest in higher education pathways and incentives for students to work in regional areas.

Some commenters claimed that covering provisional psychologists under Medicare is a bad idea. As someone who isn’t in the mental health field, I found some of these comments to the SMH article insightful.

One wrote:

I am a clinical psychologist and supervisor of trainees (provisional psychologists). The vast majority of trainees are not ready to provide services to the standard required by Medicare. They also require very close supervision and we currently have a shortage of supervisors.

BD, comment to SMH, 17 April 2023

One comment suggested a change to psychology training requirements.

I’m in the profession and the idea of Medicare subsidising trainees is a big mistake. “The government would be better off putting more money into the training system to enhance the workforce” – totally agree with that. Also, the professional body itself makes it very difficult for people who have studied for years to become an actual Psychologist – generalist undergraduate degrees, minimum masters that are impossible to get into or alternative pathways that have insanely complex requirements, and then the more recent cash cow hurdle of to do an [sic] paper exam to enter into the profession.

AP from Melb, comment to SMH, 19 April 2023

What Labor plans to do

Stupidly, the Labor cut Medicare Better Access sessions from twenty to 10 last year.

Federal Health Minister, Butler, says he wants mental health care to be more accessible. However, Labor have no policy to reform it.

What can be done?

Before working on this post, my response was simple — take a leaf out of UK’s book. Mental health services should be fully covered Medicare. (Mental health under the National Disability Insurance Scheme (NDIS) has been a disaster).

However, I realise this view is over idealistic. It looks like the training process for potential psychologists needs an overhaul. To be honest, it seems like a nightmare.

Red tape needs be cut in training psychologists. It shouldn’t be “impossible” to do a Masters or alternative pathway. Then maybe -— just maybe — psychologists might be more accessible. And, who knows, they may become properly covered under Medicare.

What do you think? How can mental health services improve? Let me know your thoughts in the comments below.

Categories
Opinion/Commentary

Treatment guidelines for ADHD have been revealed

Image: iStock

Earlier this year, the ADHD Professional Association came under fire for recommending ADHD medication under six as a first resort.

This went against the Therepeutic Goods Administration (TGA). The TGA warned against using medication as a first resort for children under six.

Well, treatment guidelines for Attention Deficit Hyperactivity Disorder (ADHD) have come out.

ADHD treatment guidelines are implemented

According to the ABC, the first official guidelines for treating ADHD have been approved.

It’s hoped that these guidelines will help improve the lives of approximately 1 million Australians that live with the condition. It also offers a uniform treatment for those who have ADHD.

So, what are the guidelines? Was AADPA’s initial controversial proposal approved?

Guidelines

According to the guidelines, diagnosis and treatment are extensive and conplex. Both psychological and medicinal treatments are discussed.

Here are some of the recommendations:

  • Clinicians (General Practitioners or psychiatrists) conduct a “comprehensive assessment” to determine ADHD diagnosis
  • If the patient has a cardiac condition, GP must contact the patient’s cardiologist for an opinion on treatment
  • The ADHD symptoms must cause “significant impairment” before medication is prescribed
  • If close monitoring is required, clinicians are advised to offer short – acting stimulants (i.e. immediate release methylphenidate or dexamfetamine)

Medications that clinicians canQQ prescribe include:

If a certain medication isn’t working, clinicians are advised to try out other medications. If all else fails, psychological interventions are advised.

People with ADHD should have access to the National Disability Insurance Scheme

Trigger warning: mental illness and suicide

Another recommendation suggests that people diagnosed with ADHD should have access to the National Disability Insurance Scheme (NDIS).

Since we’re talking about severe ADHD, in theory, I agree. However, the National Disability Insurance Agency (NDIA) has badly let people with mental illnesses down.

There have been a number of reports of people with mental illnesses waiting too long to have their NDIS plans (funding) to be approved.

Unfortunately, the result has been tragic. There have been reports of people taking their own lives while waiting for plans to be approved.

Again, people with psychosocial disabilities —including ADHD — should be supported. But the NDIS needs to be fixed so people with mental illnesses can be aporoved.

What else can be done? Make mental health free under Medicare

First, for non – Australians. Medicare is meant to make medical care in public doctors/ public hospitals more affordable. If you go to a GP, for example, you are bulk billed.

Australians with a Medicare card can go in a doctor’s office or public hospital and not get slugged with a multi – thousand dollar bill.

However, mental health care isn’t properly covered. Under the Better Access Scheme, only ten therapy sessions a year are given half price annually. This includes people who are diagnosed with serious mental illnesses.

I think this should change. I believe if you are diagnosed with a serious mental illness, all therapy should be government funded and completely free for patients. I know sone people won’t agree, but it’s how I feel.

Question to readers: I looked up medications I listed while writing this post. Lamotragine is an anti – seizure medication. Aripiprazole is an antipsychotic. How are these supposed to help with ADHD?

Categories
Opinion/Commentary

Mental health crisis: ED patients in mental distress say they won’t go back

Emergency Department sign
Image: iStock

 

TW: suicidal ideation, mental health distress. If these issues are triggering for you, please proceed with care. Seek help if you need it.

A mental health not – for – profit conducted a study that had worrying results.

The Black Dog Institute surveyed 911 participants in NSW and the ACT. Almost half of respondents who experienced suicidal distress said they would refuse to return to emergency departments or seek out further treatment.

43.5% of respondents said they wouldn’t seek out help from ED staff if they experienced suicidal distress.

Reasons given included: long delays, incomplete assessments and a lack of resources.

Associate Professor for Black Dog Institute, Fiona Shand outlined problems faced by many professionals and patients:

They know what the problems are, and they want to do more, but the processes and lack of resourcing don’t allow them to spend adequate time with patients or work in the way they would like.

 

A sign of a broken system

A participant from ACT opened up about her harrowing experience. She claimed that she went to the ED for suicidal thoughts in 2019. It exacerbated her anxiety.

Staff fast – tracked her, only to abandon her for hours. She said the experience left her “agitated”. The isolation could’ve been dangerous. When left on her own, she claimed she could leave the facility with no detection, or self – harm.

If this isn’t a sign of a broken system, I don’t know what is. Something needs to change. And it needs to change now.

People with serious mental health issues are being let down

Depressed woman sitting down distressed
Image: iStock

I’ve written before about the need to fix Australia’s mental health system.

I firmly believe that Medicare should cover mental health completely.

For patients who are diagnosed with a severe mental illness, psychology therapies should be free. An example of a country that does this is the UK.

The Government needs to expand Medicare

Why the hell are people with serious mental health issues going to ED? Because people can’t afford psychology appointments?

Will lifting the cap on Medicare reduce the need for ED admissions? Maybe.

However, if suicidal people do appear in ED, doctors and nurses need to know how treat them.

Effects of good mental health

There are reasons why I keep banging on about this. Good mental health means a better society.

If we improved mental health in our society we will improve:

  • Employment prospects: According to Urban Design Mental Health, poor mental health damages a person’s employment prospects. People with mental illnesses are 10 – 15 per cent more likely to be unemployed.
  • Family: When a person has a severe mental illness, family members are most likely to be carers. This can affect the carer’s employment, health, etc.
  • Homelessness: Another issue that people pay lip service to. 30 – 35% of homeless people are seriously mentally ill.

Too many people are literally dying because of poor mental health. More people are suffering in silence or are getting inadequate care. Enough is enough.

If you’re Australian, feel free to sign this petition for mental health to be properly funded under Medicare. 

 

 

 

Categories
Opinion/Commentary

Let’s broaden discussions on mental health and fix the system

Paper head with heart in the brain

Image: iStock

 

Content Warning: mental health and suicide

Last week had RUOK Day and Suicide Awareness Day. Media personalities and my former high school were encouraging people to check in on loved ones and reach out.

That’s all lovely. I mean it. Everyone has times when they need to talk about issues. Everyone needs a shoulder to cry on.

But what if your issues run deeper? What if you are really at crisis point?

Psychotherapies: a major gap in mental health

When RUOK Day comes around, there’s focus on depression, anxiety and the devastating affects of suicide.

While these discussions are a must, I believe there needs to be more. There are more mental illnesses that need advocacy and treatments. These include (but not limited to):

  • Bipolar disorder
  • Schizophrenia
  • Schizoaffective disorder
  • Substance use disorder
  • Borderline Personality Disorder (BPD)

All these disorders have a higher suicide rate compared to the general population.

The mental health discussion doesn’t go into the need for psychotherapies such as: dialectical behavioural therapy (DBT) and cognitive behavioural therapy (CBT). These are beyond the scope of Lifeline and Beyond Blue.

Mental health: a gap in Australia’s Medicare system

Australia has Medicare. It was first introduced in 1984. For the most part, Medicare allows Australians to access GPs and public hospitals for treatment without being left thousands of dollars out of pocket.

However, when it comes to mental health, there is a massive gap.

The Better Access Initiative

The Better Access Initiative is a scheme that gives eligible people the access to mental health services they need.

Unfortunately, it has its limits. According to Australia’s Department of Health website, the scheme offers 10 individual and 10 group therapy sessions a year.

For some people, this may be adequate. But if you require weekly or bi-weekly therapy, it’s not. For example, to be affective, a person with BPD needs bi-weekly DBT sessions a year. That’s at least 52 individual and 52 group therapy.

Australian Psychological Society encouraged change

In 2019, the Australian Psychological Society published a media release. They warned that the access to mental health services to Australians who needed it was inadequate.

In the media release, APS made a number of recommendations including:

  • More individual sessions available
  •  Group therapy sessions
  • An increase in therapy sessions for families and carers

Now, I’m guessing the Australian Government has implemented the changes by making the increase from ten to 20 sessions a year.

The APS should fight for more.

Follow UK’s example: make mental health free

Australia should look toward UK’s National Health Service (NHS). I get it has its pitfalls, but it’s philosophy is good. Mental health services should be free, even if a referral from a GP or psychiatrist is required.

Maybe the current Medicare Levy may need to be increased. Boris Johnson recently increased NHS rate another 1.25%. Maybe we should do similar here.

How much is a life worth? How much is mental health worth?

At minimum, the Government should  offer free services to people with serious mental health conditions. It may just save lives.

 

People with serious and chronic mental health issues need more than platitudes. They need more than once – a – year campaigns. They need services that they can access without going out of pocket.

What do you think? What changes can the Australian Government make to improve mental health care? Let me know your thoughts below.