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RUOK? won't fill mental health care gaps

  • 12 September 2018


In an Australia where there are 3000 suicides every year, RUOK? Day asks us to look out for each other and respond to warning signs. Such upbeat efforts to raise mental health awareness and 'smash stigma' have saved lives.

If we want to save many more lives, however, we need sustained advocacy for people who are currently let down by the mental health system. Pathways to care based on ability to pay reveal the need for a redesign.

So what are the current avenues into professional help when a person is not okay? 24/7 telephone services include emergency assistance, the Suicide Call Back Service, Area Mental Health Triage, Lifeline, Beyond Blue, and Kids Helpline. A young person may seek out a local Headspace (or Orygen if they are living in western or north-western areas of Melbourne). A student at a university may make an appointment with an on-campus counsellor.

Another step may be visiting the local GP. She may provide a mental health care plan of ten Medicare-rebated sessions with an accredited psychologist and/or other allied health professional. If the GP considers it necessary, she may refer a given patient to a psychiatrist. If this person has hundreds of dollars available, they may see a private psychiatrist before receiving a Medicare rebate. If not, they may wait to see a hospital psychiatrist for a consultation at a public out-patient clinic.

But many of these steps assume that a person has insight into their own state of mind. When a person lacks this insight, they may resist these steps. In such a case, when family or close friends are seriously concerned for a loved one, authorities generally encourage calling the Area Mental Health Triage for a specialist response. If there is an urgent need, and beds available, the loved one may be admitted to a public mental health ward.

When the treating doctors are ready to release the patient from the public ward, they may be admitted to a private ward if the patient has private health cover. For patients without access to this cover, however, the return to life outside hospital poses an additional challenge.

Every single person should have ongoing quality care available to them in their community. Currently only some people can access private wards and regular follow up from psychiatrists and psychologists in private practice. Governments should draw up plans for a redesign of this tiered system.


"We need to make sure that care