Mental health support: a “wasteland” between the GP and emergency services

While recent funding boosts demonstrate an acknowledgement of the issue, a more comprehensive overhaul of the system, and youth-focused action, is needed to tackle the spike in mental health problems.

Students and young people are suffering the highest rates of mental health problems in over a decade. This rise has corresponded with the increasing casualisation of the workforce, wage stagnation and increasing housing affordability problems in Australia’s major cities.

Despite government initiatives and “recording spending” within the sector according to the Health Minister, suicide rates are at their equal highest in just over two decades, with 1997 being the last year the per capita rates were higher than they are today.

Insights into the UNSW Counselling and Psychological Services [CAPS] portray a grossly underfunded and inadequate system, putting further financial and psychological strain on students who are forced to enter the private care system.

Suicide rates are at their equal highest in just over two decades

“It was really difficult to get into – you had to physically go the office and sign up in the morning to even be eligible for a time slot later in the day”, said one law student who wished to remain anonymous.

“It took so much out of me to even get to the office, only to be told I had to wait all day before I could actually see someone. I was so anxious I was physically ill all day.

“The female counsellor I saw was not happy that I refused [a trainee student to sit in], and I found her curt and standoffish. Although my form had said I was suicidal and engaged in self-harm, this was not addressed until the last two minutes of the appointment. I was simply given a business card with phone numbers (Lifeline etc.) and told to call them if I had issues. There was no follow up. I found the service so unsupportive I never used it again.”

Another student was told he would have to wait well over a month to get an appointment after a 20 minute consultation. Put simply by a mental health specialist I spoke to; you get what you pay for.

But while the systems offered by universities are not all doom and gloom, and provide a genuinely valuable and campus accessible service for students, a lack of funding has made professional help unaffordable for some students and young people. With graduates being unable to find work, or only being able to find casual employment or need to work multiple jobs, there’s not a whole lot left over for mental healthcare treatments after rent, utilities and expenses are subtracted.

For those living paycheck to paycheck, it’s hard to keep up.

Even with initiatives like Medicare rebates, bulk-billing doctors and the Better Access Scheme (10-medicare sessions in a year), the gap left over from an average psychologist can still sit at over $100. Compound this weekly or fortnightly for those who are the most vulnerable, and it starts to add up. This leads to young people delaying seeing a GP, or skipping medication or treatment due to cost, with reports putting this number at around 40-45%.

For those living paycheck to paycheck, it’s hard to keep up.

And with financial stress contributing to suicide rates, as is exemplified in the recent spike in suicides following the aggressive Centrelink electronic debt notices, healthcare needs to becomes more accessible if the rate is to decrease.

Founding director of Headspace, Patrick McGorry, says one of the problems is that the system is failing Australians, with a “wasteland” occupying the space between the GP and the emergency department.

“The low hanging fruit are the people who can be saved when they actually are seeking help from the health system … so many people are turned away, so many people, whether they’re in a personal crisis or they have a serious mental illness and are going through a relapse or at risk of suicidal risk.

“There are hundreds of thousands of people like that in Australia and they are being turned away in very large numbers from our health system which is failing to respond.”

While recent Headspace funding, royal commissions and summits are a good step closer, ultimately a better understanding, and sufficient funding is needed. Private professions are out of reach for many, and free services not able to meet the demand. With underfunded student services like CAPS having to turn people away, and tele-services like Kids Helpline not being able to answer 50% of contacts, Mr. McGorry agrees that these government tops ups are a start, but more needs to be done.

“If you look at the whole health system, just beyond young people, we’re spending a fraction of what we need to spend. It’s something like 15% of the health burden in Australia [but] we’re spending somewhere around 6% of the total health budget.”

Recent funding boosts to Headspace for rural centres, as well as online and tele-services like eHeadspace and Lifeline are a great start, and credit must be awarded where credit is due. However, this isn’t a problem we can just throw money at. With misdiagnosis being a prominent concern, and mental disorders like bi-polar taking 3-5 years on average to achieve a successful diagnosis, access to intermediate services, education and tangible targets need to be a priority for the government.

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