Even though a lot of work has been done to beat stigma, it can still be hard to know how to find a mental health practitioner or service provider that best suits your needs. Unfortunately many people still feel ashamed about reaching out for mental health help – in fact, a World Health Organisation study found that 30 to 80 percent of people with mental health concerns never receive treatment. Even more alarming, the study found that the more treatable the condition, the higher the rates of not getting treatment - schizophrenia (32%), bipolar disorder (50%), panic disorder (55%), major depression (56%), generalized anxiety disorder (57%) obsessive-compulsive disorder (59%), and alcohol dependence (78%).
Common reasons for avoiding treatment included:
• Shame about being mentally unwell and fear of discrimination;
• Denial and lack of insight or understanding about the warning signs of mental health problems;
• Feeling “like a failure” if they admit to not coping with life stressors or becoming unwell mentally;
• Distrust that their personal information will not be kept confidential or feeling worried they won’t be taken seriously;
• Practical barriers like assuming the fees will be too high, not being able to find appropriate professional care, not being able to get transport, or limited availability where they live.
Australia’s mental health services have come a long way over the past couple of decades. With the rise of telehealth and recent extension of Medicare item numbers for online Psychology services, access to excellent mental health information and support is now much more easily available.
Organisations like Beyondblue have put a huge emphasis on providing mental health information and support. People needing mental health information to help decide what service they need can rely on these organisations for up-to-date and valid resources to find out more about symptoms or treatment options.
Other organisations like Australia Counselling or the Australian College of Rural and Remote Medicine offer online directories that consumers can search to find a mental health practitioner. Services can be provided across vast distances using videoconferencing technology so geographic isolation is now no barrier to connecting with skilled counsellors, psychologists and psychiatrists. If you don’t feel comfortable talking with a local service provider, other options are readily available. Many of these will bulk bill through Medicare which means the cost barrier has also been removed.
Two challenges still remain – knowing whether the symptoms you’re having are just stress or whether they indicate a more serious mental health problem, and if you are having mental health symptoms, knowing what type of mental health practitioner you need. There are many different types of mental health practitioners and many people don’t understand the difference.
Even though we are all skilled in helping people recover from mental health problems, the way we go about it can be very different:
• psychiatrists (being medical practitioners) typically use a medication-based approach to resolve symptoms;
• psychologists don’t prescribe medications and focus on performing psychological testing and using psychotherapy to help patients gain insight and build skills for positive mental health;
• clinical social workers may do very similar work to a psychologist providing psychotherapy but not clinical assessments, and in addition may also work in hospitals and health services providing case management and hospital discharge planning as well as advocating for patients and their family;
• counsellors (and life coaches) provide general support and basic counselling (some in specialised areas such as drug and alcohol counselling) but don’t work with people facing more serious mental health problems.
How do you know if a mental health practitioner is genuine? This is a good question. In Australia, psychiatrists and psychologists have to be registered with the Australian Health Practitioners Regulation Agency (AHPRA) and they should always display their registration number and certificate publicly. Most social workers are registered with the Australian Association of Social Workers (AASW) which has its own code of ethics.
Counsellors also are unregistered but are encouraged to be members of professional associations such as PACFA (Psychotherapy and Counsellors Association of Australia) and ARCAP (the Australian Register of Counsellors and Psychotherapists) which set the ethical standards for their members. In addition, mental health practitioners may be members of other national and international associations which they will usually display as part of their credentialing or to confirm that they have completed training in specialised areas of practice.
Any member of the community can go to the AHPRA website to check on the registration and credentials of a mental health practitioner they are thinking of using. To be registered, mental health practitioners must have completed at least 6 years of university study (many have completed much more than the minimum), they must show that they comply with their professional development requirements including supervision every year, and they must commit to providing their services according to high ethical standards.
For example, the Psychology Board of Australia sets out all the codes, guidelines and policies that determine how psychologists must practice their profession, regardless of the setting in which they are working. Consumers have every right to check the AHPRA website or ask any mental health practitioner about their qualifications, areas of specialised training, and work experience, as part of finding the best practitioner to meet their needs – most of us welcome this level of scrutiny as it shows us that the patient is keen to get the best help to meet their needs.
Dr Kate Lemerle, Psychologist
Chrysalis Counselling & Coaching, Norfolk Island
WEB: www.chrysaliswellnessservices.com
TEL: 52112 or email drkate@iinet.net.au
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