Last week I went along to therapy, as I diligently do otherwise my brain explodes, and, after an hour of talking about how to parent and how not to panic about being on a planet hurtling through spacetime, we came to the issue of payment.
“I think this is your last session before you need a new mental health care plan,” my therapist said, pointing at her screen. “Unless – no, this referral says you have three more. But you’ve already used nine? Honestly, I don’t know.” At reception I tapped my card and we wondered if Medicare would reward me with a 24-hour wait to get some of my money back. I still don’t know if I need a new plan. No one could figure it out.
The Age has reported that Victorians are waiting about six months to see a psychiatrist, despite the state government committing $3.8bn to fix the system after the scathing 2021 royal commission. Long wait times are one problem, with many providers simply closing their books to new patients. Besides the fact that the wait itself puts people at risk – asking someone in crisis to please stay alive for six months while they wait to be seen is not healthcare – it’s an indictment on the overall quality of care.
If you’re not au fait with mental health care plans, they’re GP referrals that ask Medicare to give you a rebate on mental health care. It’s a convoluted process of attending six sessions, then a review, then four more sessions, then hoping you can afford private health insurance for the rest of the year. That’s 10 sessions, total, for each calendar year or 12-month period – no one is exactly sure which and sometimes they’re interchangeable.
This is difficult even in theory, so you can imagine what it’s like in practice.
During Covid, when pretty much everybody was suddenly made aware of their mental health, people realised how hard it all is. Faced with anxiety, isolation and depression brought on by lockdowns, loss of income and the general sense that the world would imminently end, three things became clear: mental health care is too expensive; there aren’t enough providers to go around; and mental wellbeing is really, really important to the functioning of the country and its economy.
The government added 10 “Covid” sessions to the mental health care plan, bringing the total subsidy to 20 a year. Coupled with jobkeeper and Covid payments, more Victorians than ever had what they needed to finally address long-term mental health issues.
The pandemic notwithstanding, it was a beautiful time. Suddenly, those of us who had been rationing critical sessions and keeping a stockpile for Christmas were able to undergo actual therapy. I saw my psychologist every fortnight. Instead of spending 50 minutes catching up on what had happened since last time, we were able to pick up where we left off. We dived into long-hidden traumas, deeply held fears and the root cause of my inability to cope with daily life.
It was transformative. Even amid the pressures of lockdown – which were many – I made more progress in six months than I had in the previous 10 years. When Melbourne re-emerged from weeks indoors, I was finally able to go with it.
This was only possible because I was on the books, so I didn’t have to wait. I got the help I needed. I could afford it. It was a glimpse of what a functioning mental health system might look like – and the impact it could have.
No one is cured in a single $450 psychiatry session; long-term mental wellbeing requires ongoing support, whether it’s talk therapy, medication with reviews, inpatient care or something else.
Waiting for six months is not healthcare. A recap of what’s happened since September is not healthcare. Added financial strain and a lack of psychosocial support is not healthcare.
Covid is over now, apparently, which means normal people are back to being normal and, at the end of 2022, the extra sessions will be removed. The mental health care system will, once again, revert to an occasional brush with a therapist who might be able to see you again before next Christmas.
• In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978. In the UK, the charity Mind is available on 0300 123 3393 and ChildLine on 0800 1111. In the US, Mental Health America is available on 800-273-8255
