Updated: Jan 2, 2020
You’re feeling a little tender. You’re crying, angry or feeling blue, much more than usual, and it’s been going on for a little while, so you take yourself off to your General Practitioner (GP). You tell them your woes and they may do one or all of a few things, in the space of a five or ten minute appointment:
Write you a prescription
Make a referral to a psychologist under a Mental Health Care Plan (MHCP)
Let’s look at each of these.
A K10 test is a psychological test designed to show a person’s levels of depression. A DASS test, indicate levels of Depression, Anxiety and Stress. Both of these tests use ‘in the last seven or fourteen days’ as their benchmark. These tests are also designed to be used in conjunction with other assessment tools including an interview where a practitioner assesses the reasons for responses. For instance, if you have had to sit an exam it’s likely your levels of anxiety and stress will be high, but if you don’t mention that to your doctor, because your partner leaving you for your best friend, has consumed your thoughts, the test may not be showing an accurate reading. Without a full assessment, these tests can show results that are far from the truth, and a full assessment takes time.
Most Depression check apps use these tests. You’ll notice that all the apps have a statement such as, ‘this test is for general reference only and does not replace consultation with a mental health professional’. A GP is not a mental health professional unless they specifically state as such in their qualifications. They are a doctor in general practice. If you have kidney disease you go to nephrologist, bone problems you see an orthopaedist…It’s a bit like taking a Ferrari to the garage on the corner for an oil change. They know cars, but they don’t have specialist knowledge of your particular engine, it’s possible they’ll do a good job, but you’ll probably get better results at the Ferrari garage.
Next they may write you a prescription. You may need pharmaceutical assistance, but you also may not. Many medications for depression and anxiety can take some weeks to take full effect as they build up in your system. This also means that coming off them can also take many weeks or months. There are also many different types of medication available, getting the right one is vital to treating conditions correctly. If you are prescribed medications, it’s important that you ask what it is for and how it will work. If you are prescribed medication for sleep or stress these can be additive. Again ask if this is the case.
They may also refer you to a psychologist with a mental health care plan. A MHCP is a Medicare provided services that allows an initial six sessions with a psychologist with a further four should they be deemed necessary. Often there will be a gap to pay, sometimes not, it depends on the clinician. There will often be up to a four month wait for an appointment. A psychologist is limited in the methodologies that they can use, the main one being Cognitive Behaviour Therapy (CBT). This is not a cure all method of therapy and often clients that have seen a psychologist with say, ‘therapy didn’t work for me’. Any diagnosis made by a psychologist is kept on your Medicare record and may prevent you getting private health cover or life insurance.
What a GP may not tell you is that there are other options to the above path.
In the above scenario the use of CBT for a mismatched issue may be the reason why a psychologist didn’t work out, but I may also be that the client didn’t feel comfortable or the the clinician ‘got them’. With all the suggestion below the same remains true for all of them...the relationship is the key to a good therapeutic outcome.
A counsellor: Not covered under Medicare, but will often have private health fund provider numbers, this means there is often little to no waiting time to see one. They have a number of methodologies they can use to fit your issue or personality. Counselling is generally for a single issue that can be dealt with in less than 10 sessions. The charges vary, but most counsellors will offer a sliding scale and they will often charge less than the gap of a psychologist.
A psychotherapist: Similar to a counsellor, but specialising in longer term issues that will likely take more than ten sessions. There are a number of methodologies available to be used. Many psychotherapists will have preferred methodologies (look here for the wonderful array of options). Most will have their preferred methodologies listed on their website and in the professional association profiles along with their qualifications and specialities; e.g grief, trauma, sexual health, alcohol and other drugs, early childhood etc. Always use a qualified, registered therapist. You can find therapists via the PACFA and ACA websites. Both counsellors and psychotherapist will be able to help with strategies and tools to help you manage your symptoms and issues. If they aren’t able to assist because your presenting issues are beyond their scope of practice they may refer you to a specialist service, GP, psychologist or psychiatrist.
It’s important to remember that you’ll need to have a trusting relationship with a therapist, so don’t be afraid to shop around for the best fit.
A psychologist: a specialist in mental health that is registered with Medicare and diagnoses mental health disorders and refer to psychiatrists. You can see psychologist privately, but they can be expensive and can have a different approach to counselling. You can find a psychologist via a GP referral or via the Australian Psychological Society (APS) website.
A psychiatrist: These guys are the Ferrari dealer. They are a medical doctor that specialises in mental health conditions and diagnosis. They can diagnose and prescribe the drugs. You need to be referred by a GP or Psychologist and have suspected serious stuff going on before they will see you.
Depending on the issue you may not need a MHCP and it’s worth contacting a counsellor to find out the best course of action. If you have access to an Employee Assistance Programme (EAP) through your workplace you could use one or more of your sessions for this purpose. EAP sessions are designed to provide short term solution focused counselling to either support through a single issue or refer to longer term support, this may include referring to a GP for MHCP or to another service that provides specialist counselling, such as Aids Action Council, Relationships Australia, MensShed or Victims Support.
There are so many options available to you if you’re feeling the need for mental health support. Your GP, while absolutely awesome for so many things, is may not be the best first option.