How do I Talk to Someone with a Possible Mental Health Issue?

How would you know if a friend or family member has a mental illness?

People sometimes suffer the symptoms of a mental health illness alone because they don’t want people to see them as different to other people. Having a mental illness is not a choice. They need treatment to feel better, just like someone with a broken leg. Having a friend or family member they can rely on is a BIG help.

Most people just want you to ask if they are ‘really’ OK and the offer of help if they need it. “Is there anything I can do to help?” or “I am here for you” or “I will listen if you want to talk.”

If you have a friend and you are worried about them have a think about the following:

  • Has their behaviour changed recently? e.g. becoming quiet, negative, withdrawn, stopping going out?
  • Have they been the victim of bullying lately?
  • Have they been a victim of violence or witnessed violence (physical or sexual)?
  • Have they had a tough time at home due to family issues?
  • Have they experienced the death of a loved friend or family member?
  • Have they experienced a break-up from their boyfriend or girlfriend?
  • Have they started drinking alcohol or using other drugs?

These factors might carry more risk in developing a mental illness. Encourage them to ask for help.

Have a look at this link for what to ask people with a mental illness:
https://themighty.com/2015/11/what-to-ask-people-with-mental-illness/

Check this link out for some good tips on do’s and don’ts:
http://www.mindhealthconnect.org.au/dos-and-donts-discussing-mental-health-issues

What is a Mental Health Care Plan?

The Mental Health Care Plan (MHCP) is part of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) initiative.

A mental health care plan is a plan for people with a mental health disorder. Go to this link to find out more https://www.healthdirect.gov.au/mental-health-disorders. If you have mental health issues, your doctor can write out this plan.

It identifies what type of health care you need, and spells out what you and your doctor have agreed you are aiming to achieve. It also refers you to local mental health services.

This initiative aims to improve outcomes for people with a clinically-diagnosed mental disorder through evidence-based treatment. Medicare rebates are available to people as part of this initiative, for selected mental health services provided by general practitioners (GPs), psychiatrists, psychologists (clinical and registered) and eligible social workers and occupational therapists.

This means you can see a GP or get referred to a psychologist or eligible social worker or occupational therapist and not have to pay 100% of their fee (you get part of that money refunded back from Medicare), if you have a mental health care plan. You are entitled for up to 10 individual or 10 group appointments with mental health professionals like clinical psychologists or registered psychologists, counsellors or social workers who are linked to Medicare. If your mental health professional feels you would benefit from further sessions after the sixth session, they will write a report to your GP asking for more sessions – up to four more. Each year, you could be entitled to 10 sessions through a GP referral.

Your doctor can give you a referral to mental health services in your area. If you are looking for a GP, psychologist or hospital in your local area, click here (for map).

Information about Health Professionals

General Practitioners (GPs), psychologists, social workers and psychiatrists have different although complimentary roles. They can offer services and treatments for depression and anxiety and of course, other mental health issues. Let’s start with GPs (doctors).

GPs

GPs have obtained their medical degree from university and undergo placement in hospitals before becoming a fully qualified medical practitioner. A Doctor of Medicine (MD) or Bachelor of Medicine and Bachelor of Surgery (MBBS) takes four to six years to complete. They then enter a medical speciality such as general practice which takes an additional three to five years. They are able to prescribe medication and referrals to a either a psychiatrist, psychologist, eligible social worker or occupational therapist. These professionals are called mental health professionals (MHPs).

If the GP feels you need more specialised help with medications or diagnosis (figuring out if you have a mental illness) they might refer you to a psychiatrist.

Mental Health Professionals (MHPs)

Psychiatrists

 Psychiatrists study for an undergraduate degree in medicine for 6 years; this includes biology, chemistry, maths and physics. Psychiatrists are medical doctors who undertake an internship for one year in a hospital and then a residency of one or more years in a hospital. It then takes five years of further training to become accepted into the Royal Australian & New Zealand College of Psychiatrists. They can make assessments, diagnose various mental illnesses and can offer different types of treatment and prevention of mental, emotional and behavioural disorders. Psychiatrists can prescribe medication and sometimes specialised psychological counselling with medication. Some psychiatrists work in a hospital and in private practice or combine clinical work with research.

For more information about psychiatrists go to:
https://www.yourhealthinmind.org/psychiatry-explained/psychiatrists-and-psychologists

Psychologists

To become a psychologist you can complete an accredited undergraduate degree in psychology (three years), followed by a fourth year accredited course, then you can either do

a) undertake a two year internship with supervision by a practising psychologist to become a registered psychologist (4+2 pathway)

b) complete a one-year APAC-accredited Graduate Diploma of Professional Psychology, then undertake a Psychology Board of Australia (PsyBA) regulated one-year internship of supervised practice (5+1 pathway)

c) complete a Masters of Psychology for two years to become a clinical psychologist. General registration can be followed by specialised practice endorsement through advanced supervised practice.

Psychologists can work in a range of areas such as clinical, neuropsychology, health, community, forensic, organisational, and sports and exercise psychology. Psychologists specialise in the assessment, diagnosis and treatment of mental health problems. Psychologists study human behaviour and have studied the brain, memory, learning and human development at university. Psychologists can provide psychotherapy (talking therapies) such as cognitive behaviour therapy (CBT), acceptance and commitment therapy (ACT) and interpersonal therapy (IPT).

Clinical psychologists and registered psychologists are not doctors and cannot prescribe medication in Australia. They are legally required to be registered with the Psychology Board of Australia, in the same way medical practitioners must be registered.

You don’t need a referral from a GP or psychiatrist to see a psychologist, however, you’ll need a Mental Health Care Plan from a GP to claim rebates (get some money back) through Medicare or to utilise the Access to Allied Psychological Services (ATAPS) program. Medicare rebates are available for individual or group sessions with psychologists. If you have private health insurance, you may be able to claim psychological services, but you need to check with your insurer if this is the case.

For more information about psychologists and the Medicare rebate for mental health services, go to:
https://www.psychology.org.au/Assets/Files/2013-Medicare-fact-sheet-mental-health-rebates.pdf

Social Workers

Students wishing to become a social worker undertake a four year Bachelor of Social Work degree, including practical placements which can be followed by a two year Master of Social Work. Students of Social Work study applied social sciences, including sociology, psychology, political science, public health, community development, law, and economics.

They conduct assessments, and develop interventions to solve social and personal problems and create social change. Social workers help clients cope with problems such as poverty, abuse, addiction, unemployment, educational problems, disability, trauma and mental illness. They provide individual, family and group counselling, case management services connecting clients with resources and service providers, and other services to empower clients to meet their own needs. Social workers advocate for vulnerable populations within communities, fighting to end the inequalities and injustices they see. They engage in legislative advocacy, policy analysis, and community; organising to break down barriers and drive reform on a larger scale.

The profession is regulated by the Australian Association of Social Workers (AASW) and membership is the benchmark for qualified practice in Australia. To be eligible to provide services under Medicare, social workers are assessed as meeting the requirements for accreditation as a Mental Health Social Worker. They are able to provide ‘focussed psychological strategies’ to eligible people with a diagnosed mental disorder under the Better Access initiative.

For more information about social workers go to:
https://www.aasw.asn.au/information-for-the-community/what-is-social-work

Occupational Therapists

To become a qualified occupational therapist (OT), you need to complete an undergraduate or masters entry-level course in occupational therapy. Courses are taught at universities throughout Australia. OTs working in the field of mental health, design individual and group programs and activities to enhance clients’ independence in everyday activities. They also assist clients to develop coping strategies in overcoming their mental health issues and work to improve clients’ confidence and self-esteem in social situations. Their clients may be people who are finding their personal life experiences difficult to cope with and this could include issues around grief and adjusting to loss, high emotionality, stress and parenting, but also more severe and complex mental health conditions, in addition to anxiety to depression.

OTs can also assist with developmental conditions, such as Autism Spectrum Disorder (ASD), or can help children with different medical conditions, such as cystic fibrosis or juvenile diabetes.

As with psychiatrists, psychologists, social workers, and GPs, all occupational therapists (OTs) working in Australia are required to be registered to practise. For OTs, this registration process is the legislative responsibility of the Allied Health Practitioners Registration Authority (AHPRA) and is operated through the Occupational Therapy Board of Australia (OTBA). The AHPRA website contains a directory of all registered occupational therapists in Australia.

For more information about OTs go to:
https://www.otaus.com.au/about/what-is-occupational-therapy

If you are trying to find a GP or psychologist in your local area click here

What happens when I see a MHP or GP?

  • You can get a referral to see a mental health professional (MHP) through your GP – it’s called the Mental Health Care Plan (MHCP). Your GP might inform the MHP what they think the issue might be or what you need help with.
  • The only person who can tell your story is you. The MHP will not judge you or say to you that you have done something wrong.
  • It’s confidential – whatever is said to your GP or MHP stays in the room –unless you give them written permission to tell someone else.
  • He or she will want to hear what is going on for you or help you to figure out why you might not feel that great.
  • MHPs will ask stuff about your family history and any physical or mental illnesses.
  • They will be curious about your current circumstances such as working, studying, living arrangements etc.
  • You can share what you feel OK about sharing and can always share other stuff at the next session.
  • You might leave the first session feeling: relieved or anxious or calmer or mixed up, but that is normal and you might feel different each time you go. Most people end up liking it and appreciate the insight they gain and things they learn.

If I don’t feel like the mental health professional (MHP) is listening to me what do I do?

If you don’t feel listened to and don’t feel comfortable with the MHP you can go back to your GP and ask to see someone else. That happens sometimes so don’t feel bad if it happens to you.

Just keep in mind, the first session with an MHP is generally an information gathering exercise so be patient, as the MHP is trying to get to know you at this first session. They will most likely ask you what you want to focus on the most or offer suggestions in ways they can help with your particular situation. You can say what you want to focus on if you know what your goals are, so don’t feel like you can’t let the MHP know this. They are there to help and support you, not to judge you.

Some mental health professionals don’t feel entirely comfortable in making a diagnosis after just one session, so know that they may update or change your diagnosis after additional sessions in getting to know you. They will be focusing on your symptoms and giving you information about your condition and strategies to try.

It might be worthwhile in talking to a MHP about what has been bugging you or upsetting you, whether that relates to your feelings, (e.g. feeling a sense of loss) emotions, (e.g. feeling angry but you don’t know why) relationships, (e.g. friend or boyfriend or girlfriend problems) or a past issue that you felt you couldn’t talk about with your family or friends.

If the MHP feels you would be helped by medication, he or she will contact your GP for a medication evaluation or discuss options for referral to a psychiatrist. Your GP may have already prescribed medication for you and will want to check in with you to see how that’s working out for you.

What can I ask the MHP?

In all likelihood, your MHP will provide the following information but it won’t hurt to check with them if you feel you need to know then and there. These are just suggestions and you might have other things that you want to ask the MHP, so go ahead! It is normal to feel a bit anxious at first, so don’t be hard on yourself.

    • Why did I get mentally unwell?
    • Will I get worse or improve in the future?
    • What website can I check out for more information?

About our sessions

    • What is going to happen at the first session?
    • What will we focus on in each session?
    • What form of therapy do you use?
    • Will you tell anyone about what we have talked about?
    • How often will appointments be made?

Getting help

  • Who do I contact outside of my sessions if I feel badly?
  • Who do I contact in an emergency?

For more information try these links:

What happens when I see a psychologist?

https://psychcentral.com/lib/your-first-psychotherapy-session/

What questions can I ask the psychologist?

http://www.yourmentalhealth.ie/mind-yourself/concerned/your-mental-health/questions/

Can I see a doctor/general practitioner (GP) without my parents?

Yes. If you are 16 years old or over you are considered old enough to be in charge of your medical health. Therefore, your parent or guardian does not have to be informed unless you want them to be. This means you see a GP without parent s/guardians consent if you want to. If your GP refers you to a psychologist or other MHP, they will want to talk to you by yourself. Your parent or guardian can talk to the MHP either before or after he/she sees you, but the session is all about you.

If there are family issues, your MHP might suggest your parent/guardian see another MHP. This way, you are supported but another MHP supports your parent/guardian.

Can I have my own Medicare Card?

Yes. You can apply for your own Medicare card at the age of 15 years. You will need to go to Centrelink and you need to have your student ID or birth certificate for identification.

Medication

Some comments that students provided to us about taking prescription medication is  below:


It’s OK to ask your GP if they can give you an idea of how much prescription medication might cost. If they suggest you need to see a psychiatrist, ask them if they know how much this will cost as well.

If your GP or psychiatrist thinks your condition requires prescribed medication, make sure you know how to take the medication, what possible side effects there might be and when you should notice a difference in how you feel. If it is suggested you go on medication, your GP will want to check in with you every now and then to ensure you are feeling OK.

Sometimes it’s a good idea to take someone with you to see the GP or psychiatrist because if you are feeling unwell or nervous, it’s easy to forget some of the information given to you. You know what they say – two heads are better than one!  If you don’t want to do this or this isn’t possible, take a notepad with you and write stuff down so you don’t forget.

If you have side effects, you might need to change your medication – some people are fine and some need to change, so be patient. We are all unique and our bodies vary in how we metabolise what we take in, so it goes without saying we might react to certain medications and not others.

If you experience any unpleasant or worrying side-effects from your medication, contact your GP or psychiatrist as soon as possible.

Never take other people’s medication because they are not prescribed for you and you may experience side effects. Some anti-depressants are not recommended to take with certain other medications, so you need to get the advice from your GP or psychiatrist. Always seek the advice from a health professional for example a GP or psychiatrist, who are trained in knowing drug interactions and their effects.

Some people want to try psychotherapy (talking therapy) rather than try medication. Discuss this with your GP. You both might agree to try therapy first. Some people decide to take medication and see a MHP as well.

Things that might help with or without medication

    • What you eat might also contribute to how good you feel
    • Drinking one litre of water each day per 30 kg body weight is good for you
    • Exercise is well known to help lots with depression and anxiety.
    • Sleep is super important

Why not go to the Health section of the website for tips on these important factors

How do I tell my parents or friends that I might be suffering from a mental illness like depression?

    • Try and think it through before you tell them by taking a few notes on what you want to get across beforehand.
    • Explain what has been happening as best you can. Give examples of things that have been bothering you, for example, that might be how you feel inside or how hard it is to concentrate or do things you normally liked to do, for example, hang out with friends.
    • Think about what they need to know to be able to help you. You might be surprised at the good suggestions they make.
    • If you think they might not understand, you can see your GP first before you speak to them. Your GP might suggest you bring them with you the next time so they can get information to help them understand what you are going through.

No-one asks to get a mental illness. You are not alone and it’s never too late to get help. Talk to someone you trust or take a look at some of the websites listed here to find out more about depression, anxiety and stress.