Mental Health in Australia

In the most recent National Study of Mental Health and Wellbeing, it was found that almost 44% of Australian adults had experienced a mental disorder in their lifetime, with 21% experiencing a mental disorder in the previous year (ABS 2022).

Furthermore, the most recent Burden of Disease Study by the Australian Institute of Health and Welfare (2018) found that mental and substance use disorders were among the main disease groups causing non-fatal burden in Australia at 24%, in front of respiratory diseases (9%) and just behind musculoskeletal conditions (also 24%).

The term ‘mental disorder’ covers a range of clinically diagnosable disorders that negatively impact an individual’s cognitive, emotional or social abilities (ABS 2022).

Currently, the most common mental health conditions in Australia are anxiety disorders, affective disorders (including depression) and substance abuse disorders (AIHW 2022).

Mental Health Awareness

Mental health is defined by The World Health Organisation (2022) as:

- ‘A state of mental wellbeing that enables people to cope with the stresses of life, realise their abilities, learn well and work well and contribute to their community.’

If a person is not in this state of wellbeing and does not feel that it’s achievable, they may be living with a mental illness or mental health disorder. Prominent conditions include depression, anxiety, schizophrenia and bipolar disorders.

Note that while mental health disorders can and do affect all Australians, certain groups have a heightened risk of mental illness. These groups include:

• People living in residential care
• People who live in remote and regional areas
• Pregnant or new parents
• Aboriginal and Torres Strait Islander Peoples are nearly three times more likely to be psychologically distressed than non-First Nations people
• LGBTQI+ Australians
• Females are more likely than males to experience depression and anxiety (note, however, that males are considerably less likely to report or seek help for mental health conditions).

(Beyond Blue 2020)

Mental Health Treatment Plans

A Mental Health Treatment Plan (MHTP) is a support plan for someone experiencing mental health issues (Healthdirect 2021).

A general practitioner (GP) will assess if a person has signs of mental illness and whether they would benefit from mental health treatment (Healthdirect 2021).

General signs that a person may need to address their mental health include:

• They’ve been feeling one or more of the following for two weeks or more:
  • Worried
  • Sad
  • Down
  • Angry
  • Depressed
  • Numb
  • Generally ‘not like themselves’
• The way they’ve been feeling is affecting their ability to cope at work, school or in their relationships.

(Queensland Government 2018)

Not only does creating a MHTP allow someone to be referred to appropriate support by a GP - it also gives the patient an opportunity to begin to outline how they’ve been feeling, what their needs are and what results they would like.

In most cases, a MHTP is required to qualify for government-subsidised treatment through Medicare (Healthdirect 2021).

A MHTP may include the following:

• A referral to a health expert such as a psychologist, psychiatrist, occupational therapist, counsellor or social worker
• The type of mental healthcare a person can access
• Strategies to improve (and maintain) mental health.

(Headspace 2018)

Accessing Mental Health Services under Medicare

Step 1 - Make an Appointment With a GP

Before an appointment with a GP or mental health professional, it is recommended that people write down a list of the things they want support with, such as feeling less anxious in certain situations or how to cope in depressive periods. It’s normal to feel nervous going into this appointment.

A list may be a helpful prompt and a useful backup. A patient could even give it to the health professional to read first and ask questions about what has been written down.

Step 2 - Talk to a GP About Mental Health Concerns

A GP will assess the patient’s mental health. They will need to diagnose the patient with a mental health condition to create the treatment plan. In order to do this, the GP will ask a series of personal questions to find out what’s been happening and how the patient has been feeling recently (Queensland Government 2018).

The patient may be asked to fill out a K10 form, which is a checklist intended to measure if and how a person has been affected by anxiety or depression over the past four weeks (Queensland Government 2018).

A mental health assessment conducted by a mental health clinician will likely consist of finding out the following:

• Presenting problems
• History of presenting problems
• Current functioning
• Relevant cultural issues
• Previous assessments and interventions
• Psychiatric history
• Current medications
• Medical history
• Family history
• Developmental history
• Substance use
• Forensic and legal history
• Risk screen
• Goals for treatment
• Mental status examination.

(Queensland Health 2010)

If a person is diagnosed as having a mental disorder, their GP may either prepare a MHTP, or refer them to a psychiatrist who would create a psychiatrist assessment and management plan (DoH 2017).

Step 3 - Be Referred to an Allied Health Service

A patient can be referred to Medicare-rebateable allied mental health services if they:

• Have a Mental Health Treatment Plan in place (note that a MHTP does not expire)
• Are being managed by a health practitioner under a referred psychiatrist assessment and management plan, or
• Are referred by a psychiatrist or paediatrician.

(DoH 2017)

Step 4 - Attending Sessions

Initially, a GP, psychiatrist or paediatrician can refer a patient to treatment of up to six individual and six group allied mental health services. Treatment plans will vary upon the individual and might involve psychological assessment and therapy by a clinical psychologist, or could consist of psychological strategies conducted by an allied mental health professional (DoH 2017).

It is at the discretion of the referring practitioner as to the number of allied mental health services a patient is referred to (it is a maximum of six in any one referral) (DoH 2017).

Step 5 - After the Six Sessions

Following the first round of treatment (six sessions or less), depending on the patient’s healthcare needs, they may want to return to their GP, psychiatrist or paediatrician and obtain a new referral for additional sessions. Per calendar year, the maximum is 10 individual and 10 group services (Services Australia 2022a, b).

Note: In August 2020, the maximum number of individual sessions per calendar year that patients could access was temporarily increased from 10 to 20 in light of the COVID-19 pandemic. However, after 31 December 2022, this will revert to the original allowance of 10 individual sessions per calendar year (Worthington 2022; Services Australia 2022b).

If a person feels that they require more than 10 services in a calendar year, they can see their GP and/or treating practitioner to discuss other available options, such as services available through Primary Health Networks (DoH 2017).

Conclusion

Obtaining a MHTP is a huge step towards becoming happier, healthier and more connected.

The difference mental health treatment can make to a person’s wellbeing cannot be overstated.

If you’re in crisis and need immediate support, call Lifeline on 13 11 14. Lifeline is open 24 hours a day, 7 days a week.