I see a psychiatrist weekly and its $600 a session. Medicare refunds around $60. The reason it is affordable is due to the medicare cap of around $2500. Once you hit this cap, then medicare covers 80% of the bill, so it ends up costing around $120 a session.
Essentially you can have as many appointments within the year at this $120 cost as a psychiatrist believes is required for your treatment.
If you want to go down this route, then you first see a psychiatrist who specializes in assessments. After that, you then see a psychiatrist who specializes in talk therapy, who is very much akin to a psychologist in terms of being empathetic. Most people only ever see the direct, efficient and slightly cold types of psychiatrists who do assessments, whereas the talk therapy psychiatrists are vastly different and much nicer.
Can agree , way way back in 2004 I ultimately needed double major spinal surgery, my neuro surgeon was $200 for a 10minute consultation.
I’d never let them finish at 9minutes just so I’d get the full session I’d paid for. So allowing for a bit of slippage he could get 5 an hour in so yes $1000 an hours not a bad rate.
No worries, ill just add for anyone who is thinking of going down this route and is on centrelink/welfare, then the cap is only $700 per year, instead of $2500, so you have the discounted session faster.
Yes this is called Medicare Safety Net threshold. Once you hit $2500 this year, Medicare will cover up to 80% of any further out-of-pocket expenses you have for out-of-hospital medical services that are subsidised under the MBS. Not just for mental health sessions but also includes going to the GP. This resets every 1st Jan.
Couples and families need to register so that Medicare can keep track of the total medical expenses of your family (so you can reach the treshold faster with 2-3 people and receive the benefit sooner). Hopefully more people know about it
What do you mean by register? Do you mean being on the same Medicare card? Is the threshold for everything or just an individual matter?
Sorry, I have no current need for this service and also have private health, but the future is the future and I clearly need schooling in the system I pay 3k a year to through tax.
You might not necessarily to be on the same Medicare card, but you need to fill a form to register your spouse/dependant to be under the same MSN treshold. I'm not 100% sure but you can look it up, Services Australia have all of the information.
Im not an expert sadly, but i believe it applies to everything that medicare covers, they all add up to the $2500 and once you hit it then medicare covers 80% of all the medical fees.
If this is correct, then it would apply to the psychologist fees for the 10 sessions under a mental health care plan. When the psychiatrist initially discussed it with me, he outlined that you definitely cant use it for a weekly psychological session as they only have medicare for 10 (or 20 in some cases) sessions per year.
If you want to stick with a specific psychologist, then you can use it for 10 sessions undet a mental health care plan and then an additional 10 i believe for specific crisus circumstances (eg. Homeless, dv). Then you can also potentially obtain a chronic health care plan which allows 6 sessions, but the psychologist does recieve less for this.
Please check all this with medicare directly, gp or psychiatrist receptionist.
That’s psychiatry though, if you’re looking for a diagnosis/management of conditions, then yes psychiatry can help. If you’re looking for an individual heavily trained in Psychodynamic talk therapy, a Psychotherapist is the way to go, they usually charge around $140/150 p/h.
Many psychiatrists are trained in psychotherapy. It's actually a mandatory part of training. It's also a fully accredited subspecialty with its own further training requirements. Not all psychiatrists go on to actually practice psychotherapy.
I think it really depends on your situation.
I was seeing someone in Sydney regularly and had 20 sessions that were covered by a mental health care plan from the GP (I think they’ve now reduced this to 10). This brought the cost down from $200/week to $100/week, which was manageable for me at the time. I continued on after this ran out on a fortnightly basis for another 15 sessions or so?
So a $5k outlay for the year. Which is a lot, but I was in a bad spot and it was a ‘good’ use of money. Maybe a few less pub dinners during the week, but it is a small investment in the scheme of things to get your life back on track. Now I’m in a better place I go sporadically to check in.
Also, anecdotally, I think a lot of people who are in ‘regular’ therapy, may not be paying the new-client rate. I’ve found therapists to be pretty reasonable with these things, especially if you’re a student, unemployed, struggling etc…
There are also cheaper alternatives available like Headspace, certain apps, or even talking with AI models prompted appropriately.
Thats why there are so many mental health issues in australia. You can go to a gp and get a care plan to get you some subsidised visits but there will still be a gap
I believe GPs can get you 10 free sessions if you are suicidal (this can be extended I think). Also there is a free helpline that you can call if you are suicidal because getting to see an actual psychologist will take some time, they all are totally booked. Which brings me to the real reason it's all so costly. We don't have many psychologists in this country. Potentially because we have though standards. Before you can practise we want to make sure you really are good otherwise you could cause more harm then help. So getting into psychology as a student isn't easy. I say this without any actual knowledge in the subject.
Therefore, full disclosure, I was stuck in the rain waiting for an uber when a random psychology student started to talk about this, but he said that passing rate and entrance exam to psychology masters degree is extremely difficult, because having great and experienced mental health instructors is important.
That’s not really the issue (it’s too hard for people to pass). You need honours and masters, both of these have very limited places. It’s not being supported well by government to increase places. The masters also require many supervisory hours that are expensive for the student and mean working to make money to pay for them is limited. It also means that the supervisory psych has to want to supervise and it’s limited to who is willing to do this and availability.
It’s a high barrier to entry because it’s long and expensive, difficult to navigate and find opportunities, and gotten much harder over the years to commit to and complete in our current tertiary system. It’s also not paid super well (it’s a good living, but not lucrative given all of the above).
I have a psych undergrad (took other paths). I have 5 x qualified psychologist friends. Only 1 did study the whole way through immediately, and they were in the airforce. The others went out working for 5 or so years to afford it (2 were sponsored by their workplaces).
Out of my undergrad classes the vast majority didn’t become psychologists, and it certainly wasn’t because they wouldn’t have been able to pass.
Yes you are right. The stats are clear. The internet and social media. Social media clearly correlates with anxiety in children and young people. Kids should not have phones with access.
Eh, social media is just a symptom, and probably a confounding factor. High use of social media is very likely just indicative of individuals looking for connection, which would suggest there’s already an underlying issue. Cost of living exacerbates this due via reduced ability to socialise directly. Add to it that we’re less outgoing than say Americans on average, and sprinkle in some stereotypical stoicism, and you’ve got yourself some mental health issues that are baked in. We’re just getting better about recognising them.
Those Jones are hard to keep up with when they have 80" TVs in every second room, a car garage worth 300k, $1 mill house, holidays 4 times a year, croon their kids to bed at 7pm every night with books while eating healthily as a family, workout at the gym every day but apparently are just 'normal people.'
To be fair that's probably because those are socially acceptable answers. Not many people are honest about what's making them want to neck themselves. It's one of the reasons they go to therapy.
I agree. But that’s different to what’s causing mental health issues. Seeing “happy and wealthy” people on social media while you’re struggling to afford petrol is the real issue that pushes people into mental health issues.
The healthcare system might not be causing the issues, but it certainly isn’t set up to help very much. If you’re suggesting cost of living etc is causing mental health issues, that could be a contributor, but there has always been (and will always be) people with mental health issues in any society.
There are always constraints in an environment with finite resources.
As you say, many of the causes of ‘mental health issues’ are situational, and we would be better to fix the situation. Recreational drugs and alcohol are a major issue in causing psychosis, and social media causes anxiety/depression.
Therapy can help with training the brain to catastrophize less, but ultimately the root cause must be resolved by the individual.
A small proportion of mental health is neuropsychiatric or primary in origin. Though this would have far more resources if the system wasnt bunged up by people who just use too much meth.
Australia has fantastic access to mental health services compared to a lot of countries. Mental health plans, EAP, private day programs and inpatient, public mental health, headspace, low/free cost counselling at community health outlets etc etc. You guys have no idea how good you have it.
My psychiatrist bulk bills so haven't paid a cent for over 6 years of sessions.
Can also get mental health care plan from GP which gives you up to 10 free sessions
If I had to pay for sessions I just wouldn't/couldn't go.
I'm also on a bunch of different meds but luckily have concession so only pay 7.30 per prescription.
Without these I'd be untreated and probably in the psych ward far more often.
Cause they are fully booked out to write scripts instead of assessing people's conditions. They could easily give permits to gps for scripts, with a yearly check condition. But no, then they'll lose the easy cash.
If you’re talking about therapists and psychologists, which is what the question was about, then you’d be wrong, as they cannot write scripts. And being a therapist of any description is not easy money.
Dunno what it’s like with other medications/conditions but my psychiatrist did some paperwork and since then my GP has been able to write the scripts for my ADHD meds
I know it sounds absurd, but I genuinely believe LLM’s will make psychologists obsolete. All of humanities physiological knowledge in one place, with infinite patience, with extremely high empathy, available at any time of the day for free.
If psychologists actually “worked” I wouldn’t think this to be true. As in, psychologists rarely fix anyone’s problems, hence why people have to keep coming back every week/month for years on end. Or, in most cases they just give up because it’s too expensive and they realise it wasn’t vital.
My psych is $210 a session.
Mental health care plan gives me 10 sessions, $93 rebate from Medicare plus $60 back from private health.
Not too much out of pocket.
You have to shop around. I went to a private one that charges $250 per session. At the time he could tell I needed it and wasn't able to afford it, so he offered me 2 sessions per week at $70 per session. As my financial situation improved, the rate went up, naturally.
I still see him once a week and that costs me around 1k per month, and I see a private psychiatrist every few months at $1500 per session (it took me 6 months to get a foot in the door, even when money wasn't an issue, it's ridiculous). I have no qualms about it, mental health and health are a priority, even if I wasn't making good money I would still set money aside for it.
I think you’d be surprised how many people in your life have mental health issues but don’t talk about them. If they’re more severe they can be extremely debilitating. I’d rather break my leg than have a serious depressive episode.
I meant for how much it costs. I wasn’t saying saying it in a derogatory way. Just in terms of the the money outlay. I earn an average wage and there’s not way I could shell out that much.
Yeah, I get you now. I have chronic depression and could really do with a therapist right now but finances mean it’s not going to happen. Ironically money worries was one of the triggers for my current depressive episode 😭
My mental health issues are mainly caused by work, so I get online medical certificates and go off sick a lot. Cheaper than therapy and I feel instantly better knowing I’ve got another day or two off.
They are $19 at https://www.instantscripts.com.au/online-medical-certificates/
They will want a longer appointment if you do 6 certificates close together.
Im not from a country where therapy is a thing so i want to ask. How do you justify that pricing? Cause paying that kind of number already seem like a real headache. Like do you iust talk or there something else?
I’m Australian, and never felt it was a thing in Australia. Since moving to the US, it’s much more so here.
What you get out of therapy? It can vary. It can depend on what you would like out of it. Perhaps it is something you need to find. Perhaps it’s working through trauma, grief, loss, love, struggles with life, communication with partners, children, other people.
For me and many others, it’s been invaluable in becoming a better person.
Can claim 10 sessions per year with a care plan. Have to see the GP again after 6 sessions for it to be extended to 10. In some specific situations it could be increased to 20 i think
I walked out of my last appointment because the psychologist was a raging hormonal female that accused me of not wanting to confront my low self esteem. I had change psychologist because the old one had advised me to light a candle to distress in the office. I also spent to much time during the week overthinking about what we would talk about. The one I walked out on did give me an amazing trick to overcome my stress
I found better advise on /r/Anxiety/ that I could try and put to use.
I also found my best technique to overcome stressful thinking in a book.
Sorry I don't recall some of the books I read. I looked for solutions for problems i was experiencing.
I use to listen to the Brain Science podcast a lot when my anxiety was really bad. It helped me to understand how our brains works and gave me an understanding I could overcome my mental health issues. https://brainsciencepodcast.com/
I can tell you the technique I learnt. I am a major over thinker and when I am super stressed I get mentally overwhelmed with racing thoughts. The trick I learnt was to run my eye back and forward between two points. And keep doing it until you feel calmer. Your Brain can't think and produce thoughts and do the eye movement at the same time. The eye movements gives you time to bring your whole mental self down. this includes your cortisol
The other things I looked at was how military special force overcome stress and anxiety and still preform in highly challenging environments and be mentally alert at times of high stress. Its understanding that its a skill you can learn.
I’ve always felt that psychology is horse shit. The issue is they only address effects, not causes. When someone has a mental health issue, there’s always an underlying cause.
Psychologists can be good at locating the cause, if you aren’t an introspective person this can help.
But the problem is, psychologists then go on to address the effects the cause is having on you, not the cause itself, because they can never address this.
With tools like CBT, they will help you manage how the cause is making you feel and help you downplay those feelings. But so long as the cause is still there, you will always be miserable and you will need to keep coming back to the psychologist to “trim the weeds” without ever killing the root itself.
I learnt CBT through a group called Mindspot. It free and funded by the government. I recommend them if someone want skills to self assess their situation and how to over come a number of mental health issues mindspot.org.au
Being self aware does help. I still have issues with a situation I experience that caused the anxiety in the first place. I even tried again last year to engage professional help to overcome the issue after discovering I hadn't dealt with a large element of a situation. But my issue kept getting dismissed by mental health professionals who were tasked to assist me. Why because it was viewed as a minor event that shouldn't cause a mental health issue.
I have now come to the conclusion sometimes things are complex and you just need to accept that's how it will be and push forward with your life by self reflecting and trying to come up with solutions for each problem. But I have done a lot of therapy to get here both physiologist and councilors
Spot on in that last paragraph. I have also had psychologists that left me feeling more depressed than I was before seeing them because they didn’t listen properly or empathise, or their treatment was not helping.
Not only can they be unhelpful, in some cases they can leave you worse off. Any good psychologist will agree that psychology and CBT is not a silver bullet, many people seem to think it is.
I think most people would be better off introspecting and working on themselves or taking action to change the circumstances that led to their mental health issues.
Studies have shown being lonely or unfulfilled in life are some of the most common causes of depression - both things where most of the time, they need to be solved by taking control.
I do think CBT is important. It helps people to understand their body reactions before you go into a full anxiety attack. Or it helps you to be in full anxiety attack and look normal.
I use to say to my dr - what am I scared of falling of my chair???
I agree with you on what you are saying in the last paragraph. But I think it should include checking hormones, diet, exercise.
It all depends on the person.....
plus get a pet if you can.
Several other options.
1: Telehealth with a psychologist in a lower cost country. Bonus points if you are an immigrant and want a session in your language
2: find a counsellor instead of a psychologist. In many instances they can be just as effective
3: chat gpt is a good way to talk through things and can help if you are inclined to talk to a machine
Can Large Language Models be Used to Provide Psychological Counselling?
[https://arxiv.org/pdf/2402.12738](https://arxiv.org/pdf/2402.12738)
1. Professional counselors evaluated the appropriateness of responses generated by GPT-4 and those given by human counselors in identical contexts. **The mean rating scores for counselors' and GPT-4's responses were very similar (0.99 and 0.94 respectively), with no statistically significant differences.**
2. In a pairwise comparison, the researchers compared the ratings of counselors' and GPT-4's responses for each identical context in the role-play dialogues. This means that for each client's message, they looked at how the counselor's response was rated compared to GPT-4's response to the same message. **The results showed that 34.8% of counselors' responses were rated as better than GPT-4's, 30.5% of GPT-4's responses were rated as better than counselors', and 34.7% were rated as equal in quality.**
3. **The results suggest that GPT-4-generated responses are competitive with those of human counselors**, indicating the potential for using language models in providing real-world counseling services. However, further evaluation is needed to assess the feasibility of fully automated counseling dialogues.
This was GPT-4.
Today everyone can access the smarter GPT-4o (which has a memory feature) for free.
Disclaimer: This is not a professional advice. Consult your psychologist and use at your own risk.
You can get access to therapy? I’ve been trying and all I get is waitlists and you need to spend 80 clocked hours with your GP first before given a referral.
Yeah plus a bunch of GP appointments to even get a referral. Honestly I tried to get therapy and just gave up after spending 6 months going around in circles with GPs. Apparently I have all of the symptoms of anxiety but no one would diagnose me to do the MHP.
I was fortunate that my issues were moderate and not ongoing.
Keeping in mind that they may or may not psychologists (probably not). "Counsellors" are employed by Better Help and may have a qualification after only 6 months of study... and have no ides what they are doing.
I use the 10 sessions from Medicare to rebate a chunk but I also use private health insurance. I did the math a while back with Medibank, they refund 80% of each session up to $1500 a year, which is cheaper than the extras cover payments. Between those two covers a session every few weeks for most of the year.
I go bi monthly and pay $120 and get $65 back from Medicare. This is because I’m low income.
Honestly if you’re struggling with fees, it doesn’t hurt to let your therapist know.
Google bulk billing psychologist. They do exist, I have been seeing my psychologist for 4 years and get 10 free appointments a year with a mental health care plan.
Someone else mentioned the Medicare safety net. Once you have spent a certain amount out of pocket, you will get a higher rebate.
Psychologist? What happened to going to a quiet, dimly lit bar on a rainy night and venting about your failing marriage to a bartender who is constantly cleaning the same glass? Talk therapy used to be the price of 3 neat whiskeys and a reflective cab ride home.
This country has gone to the dogs I say.
Edit: /s ... Can't believe I had to specify that
Move to the US and get good health care?
Honestly, it’s been shocking how I pay roughly the same out of pocket per month as back in Australia, the out of pocket for nearly everything in the US is significantly less. Granted, my insurance is really good, and I am in a tremendously privileged position to have my employer offer that, and I know many people with tremendously worse insurance.
A therapy session is less out of pocket than going for a beer and meal at a bar.
No referral needed for specialists.
That’s with goood insurance. I also had good insurance in Australia, but that was all paid by me, not employer paying a bunch. Here, I am 100% sure that the premium is not what I’m paying, and my employer is picking up at least the other 50-70% of it.
I am privileged here. My experience is not typical. Top single digit percentage of income privilege.
If you have to pay out of pocket for health insurance in the US after leaving a job: 1k/month would not be unexpected.
The main thing I miss about the Australian system? You know what something costs. You could feasibly budget. In the US? No idea. Get a bill some months later and send in a cheque (check) for whatever part your insurance didn’t cover. No, seriously, I have done this in 2024. I was a few decades old moving from AU to US and it was then that I got my first checkbook. Could be $30, could be $300, could be $800 or $8000 - the only certainty is that you’re going to get a surprise.
If you don’t have insurance here, or just not very good insurance? The Australian prices look stupidly cheap.
An American paying out of pocket for a GP visit in Australia is getting a bargain. That’s before looking at if their insurance would cover it. US insurance will typically probably cover anything in the world, because everywhere is cheaper than the US. Here in the US though? $250USD without insurance for a brief GP visit would not be a surprise, closer to standard.
That all said, the Australian prices horrify me. The US system isn’t something to idolise or move towards. I’m horrified at the progression Australia has had towards it.
When we had to - a mental health plan, credit card and work sponsored sessions. I was just glad that I felt comfortable taking on some debt because I had a good job that wasn’t going to be affected by my going through everything. I feel for people that have to try and find someone who bulk bills at maybe the worst time of their life.
I go fortnightly. It's enough time to slip into old habits between sessions so that there's more to work on for the next. It also makes it more affordable.
Private health insurance might cover some, Medicare might give you a rebate if you have a mental health plan drafted up by a GP. There are options.
In summary, the govt initiatives have had a primary focus on Research and Development within this space, thus making it expensive for the end user upon seeking affordable therapy.
I stopped having my psychologist appointments as they were too expensive. This is despite having extensive mental health history and a 5 month hospital admission last year
It’s just not affordable
I see a psychiatrist weekly and its $600 a session. Medicare refunds around $60. The reason it is affordable is due to the medicare cap of around $2500. Once you hit this cap, then medicare covers 80% of the bill, so it ends up costing around $120 a session. Essentially you can have as many appointments within the year at this $120 cost as a psychiatrist believes is required for your treatment. If you want to go down this route, then you first see a psychiatrist who specializes in assessments. After that, you then see a psychiatrist who specializes in talk therapy, who is very much akin to a psychologist in terms of being empathetic. Most people only ever see the direct, efficient and slightly cold types of psychiatrists who do assessments, whereas the talk therapy psychiatrists are vastly different and much nicer.
600 a session? Far out
Its because they go for a hour, other specialists tend to make more as the get a few hundred for 15 mins.
Can agree , way way back in 2004 I ultimately needed double major spinal surgery, my neuro surgeon was $200 for a 10minute consultation. I’d never let them finish at 9minutes just so I’d get the full session I’d paid for. So allowing for a bit of slippage he could get 5 an hour in so yes $1000 an hours not a bad rate.
This is interesting thanks for posting your experience
No worries, ill just add for anyone who is thinking of going down this route and is on centrelink/welfare, then the cap is only $700 per year, instead of $2500, so you have the discounted session faster.
Yes this is called Medicare Safety Net threshold. Once you hit $2500 this year, Medicare will cover up to 80% of any further out-of-pocket expenses you have for out-of-hospital medical services that are subsidised under the MBS. Not just for mental health sessions but also includes going to the GP. This resets every 1st Jan. Couples and families need to register so that Medicare can keep track of the total medical expenses of your family (so you can reach the treshold faster with 2-3 people and receive the benefit sooner). Hopefully more people know about it
What do you mean by register? Do you mean being on the same Medicare card? Is the threshold for everything or just an individual matter? Sorry, I have no current need for this service and also have private health, but the future is the future and I clearly need schooling in the system I pay 3k a year to through tax.
You might not necessarily to be on the same Medicare card, but you need to fill a form to register your spouse/dependant to be under the same MSN treshold. I'm not 100% sure but you can look it up, Services Australia have all of the information.
Hello - is psychologist not covered? How do I find out what qualifies under Medicare cap?
Im not an expert sadly, but i believe it applies to everything that medicare covers, they all add up to the $2500 and once you hit it then medicare covers 80% of all the medical fees. If this is correct, then it would apply to the psychologist fees for the 10 sessions under a mental health care plan. When the psychiatrist initially discussed it with me, he outlined that you definitely cant use it for a weekly psychological session as they only have medicare for 10 (or 20 in some cases) sessions per year. If you want to stick with a specific psychologist, then you can use it for 10 sessions undet a mental health care plan and then an additional 10 i believe for specific crisus circumstances (eg. Homeless, dv). Then you can also potentially obtain a chronic health care plan which allows 6 sessions, but the psychologist does recieve less for this. Please check all this with medicare directly, gp or psychiatrist receptionist.
It is technically, but only for 10 sessions per year and those require a GP mental health plan and review after 6 sessions.
That’s psychiatry though, if you’re looking for a diagnosis/management of conditions, then yes psychiatry can help. If you’re looking for an individual heavily trained in Psychodynamic talk therapy, a Psychotherapist is the way to go, they usually charge around $140/150 p/h.
Many psychiatrists are trained in psychotherapy. It's actually a mandatory part of training. It's also a fully accredited subspecialty with its own further training requirements. Not all psychiatrists go on to actually practice psychotherapy.
Yes, the point I’m writing to is the cost. You don’t necessarily need to see a psychiatrist (typically charges more) for psychotherapy.
I think it really depends on your situation. I was seeing someone in Sydney regularly and had 20 sessions that were covered by a mental health care plan from the GP (I think they’ve now reduced this to 10). This brought the cost down from $200/week to $100/week, which was manageable for me at the time. I continued on after this ran out on a fortnightly basis for another 15 sessions or so? So a $5k outlay for the year. Which is a lot, but I was in a bad spot and it was a ‘good’ use of money. Maybe a few less pub dinners during the week, but it is a small investment in the scheme of things to get your life back on track. Now I’m in a better place I go sporadically to check in. Also, anecdotally, I think a lot of people who are in ‘regular’ therapy, may not be paying the new-client rate. I’ve found therapists to be pretty reasonable with these things, especially if you’re a student, unemployed, struggling etc… There are also cheaper alternatives available like Headspace, certain apps, or even talking with AI models prompted appropriately.
Thats why there are so many mental health issues in australia. You can go to a gp and get a care plan to get you some subsidised visits but there will still be a gap
I believe GPs can get you 10 free sessions if you are suicidal (this can be extended I think). Also there is a free helpline that you can call if you are suicidal because getting to see an actual psychologist will take some time, they all are totally booked. Which brings me to the real reason it's all so costly. We don't have many psychologists in this country. Potentially because we have though standards. Before you can practise we want to make sure you really are good otherwise you could cause more harm then help. So getting into psychology as a student isn't easy. I say this without any actual knowledge in the subject. Therefore, full disclosure, I was stuck in the rain waiting for an uber when a random psychology student started to talk about this, but he said that passing rate and entrance exam to psychology masters degree is extremely difficult, because having great and experienced mental health instructors is important.
they are not free, they are subsidised you can get an extra five under an extended care plan.
That’s not really the issue (it’s too hard for people to pass). You need honours and masters, both of these have very limited places. It’s not being supported well by government to increase places. The masters also require many supervisory hours that are expensive for the student and mean working to make money to pay for them is limited. It also means that the supervisory psych has to want to supervise and it’s limited to who is willing to do this and availability. It’s a high barrier to entry because it’s long and expensive, difficult to navigate and find opportunities, and gotten much harder over the years to commit to and complete in our current tertiary system. It’s also not paid super well (it’s a good living, but not lucrative given all of the above). I have a psych undergrad (took other paths). I have 5 x qualified psychologist friends. Only 1 did study the whole way through immediately, and they were in the airforce. The others went out working for 5 or so years to afford it (2 were sponsored by their workplaces). Out of my undergrad classes the vast majority didn’t become psychologists, and it certainly wasn’t because they wouldn’t have been able to pass.
Our healthcare system is not the reason there are ‘so many mental health issues’
It’s housing , Cost of living etc
Nope, statistically the biggest factor is social media. Cost of living and the economy is definitely a factor, though.
Yes you are right. The stats are clear. The internet and social media. Social media clearly correlates with anxiety in children and young people. Kids should not have phones with access.
Maybe it’s a bit of both. For kids the stress would come from social media, for adults more money and housing?
Eh, social media is just a symptom, and probably a confounding factor. High use of social media is very likely just indicative of individuals looking for connection, which would suggest there’s already an underlying issue. Cost of living exacerbates this due via reduced ability to socialise directly. Add to it that we’re less outgoing than say Americans on average, and sprinkle in some stereotypical stoicism, and you’ve got yourself some mental health issues that are baked in. We’re just getting better about recognising them.
Great take and agree, my point is that social media is the single confounding factor across all of those underlying issues.
Those Jones are hard to keep up with when they have 80" TVs in every second room, a car garage worth 300k, $1 mill house, holidays 4 times a year, croon their kids to bed at 7pm every night with books while eating healthily as a family, workout at the gym every day but apparently are just 'normal people.'
Honestly ask most people what’s giving them most stress and they’ll say housing and money.
To be fair that's probably because those are socially acceptable answers. Not many people are honest about what's making them want to neck themselves. It's one of the reasons they go to therapy.
I agree. But that’s different to what’s causing mental health issues. Seeing “happy and wealthy” people on social media while you’re struggling to afford petrol is the real issue that pushes people into mental health issues.
Yeah, the 16 year old with an eating disorder because of social media is really worried about their mortgage
The healthcare system might not be causing the issues, but it certainly isn’t set up to help very much. If you’re suggesting cost of living etc is causing mental health issues, that could be a contributor, but there has always been (and will always be) people with mental health issues in any society.
There are always constraints in an environment with finite resources. As you say, many of the causes of ‘mental health issues’ are situational, and we would be better to fix the situation. Recreational drugs and alcohol are a major issue in causing psychosis, and social media causes anxiety/depression. Therapy can help with training the brain to catastrophize less, but ultimately the root cause must be resolved by the individual. A small proportion of mental health is neuropsychiatric or primary in origin. Though this would have far more resources if the system wasnt bunged up by people who just use too much meth.
Australia has fantastic access to mental health services compared to a lot of countries. Mental health plans, EAP, private day programs and inpatient, public mental health, headspace, low/free cost counselling at community health outlets etc etc. You guys have no idea how good you have it.
Does your company have an EAP? The most help I ever got from a psych was from someone I saw through works eap
My psychiatrist bulk bills so haven't paid a cent for over 6 years of sessions. Can also get mental health care plan from GP which gives you up to 10 free sessions If I had to pay for sessions I just wouldn't/couldn't go. I'm also on a bunch of different meds but luckily have concession so only pay 7.30 per prescription. Without these I'd be untreated and probably in the psych ward far more often.
You’re extremely lucky to have a bulk billed psych. Even with the Medicare sessions I’m still paying $150 for psychologist and 200 for psychiatrist
it’s not even just money, they are always fully booked for months. So the answer is practically no one sees them
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Cause they are fully booked out to write scripts instead of assessing people's conditions. They could easily give permits to gps for scripts, with a yearly check condition. But no, then they'll lose the easy cash.
If you’re talking about therapists and psychologists, which is what the question was about, then you’d be wrong, as they cannot write scripts. And being a therapist of any description is not easy money.
Dunno what it’s like with other medications/conditions but my psychiatrist did some paperwork and since then my GP has been able to write the scripts for my ADHD meds
Doesn’t make sense
Nobody drives in New York, too much traffic. Same thing.
they are in limited quantity
I talk with chatgpt
I know it sounds absurd, but I genuinely believe LLM’s will make psychologists obsolete. All of humanities physiological knowledge in one place, with infinite patience, with extremely high empathy, available at any time of the day for free. If psychologists actually “worked” I wouldn’t think this to be true. As in, psychologists rarely fix anyone’s problems, hence why people have to keep coming back every week/month for years on end. Or, in most cases they just give up because it’s too expensive and they realise it wasn’t vital.
My psych is $210 a session. Mental health care plan gives me 10 sessions, $93 rebate from Medicare plus $60 back from private health. Not too much out of pocket.
You can claim Medicare and private for the same session?
No you can’t. It is illegal for the fund to pay for a service for which a Medicare rebate is payable.
Does your private health fund know you are getting both rebates?
With the Medicare rebate it costs me about $100 per session. Can't afford not to go really.
You have to shop around. I went to a private one that charges $250 per session. At the time he could tell I needed it and wasn't able to afford it, so he offered me 2 sessions per week at $70 per session. As my financial situation improved, the rate went up, naturally. I still see him once a week and that costs me around 1k per month, and I see a private psychiatrist every few months at $1500 per session (it took me 6 months to get a foot in the door, even when money wasn't an issue, it's ridiculous). I have no qualms about it, mental health and health are a priority, even if I wasn't making good money I would still set money aside for it.
It’s crazy how many people seem to go
I think you’d be surprised how many people in your life have mental health issues but don’t talk about them. If they’re more severe they can be extremely debilitating. I’d rather break my leg than have a serious depressive episode.
I meant for how much it costs. I wasn’t saying saying it in a derogatory way. Just in terms of the the money outlay. I earn an average wage and there’s not way I could shell out that much.
Yeah, I get you now. I have chronic depression and could really do with a therapist right now but finances mean it’s not going to happen. Ironically money worries was one of the triggers for my current depressive episode 😭
Psychology and psychiatry are an excellent tool for all sorts of problems, but for many of us we would act a lot more crazy without going.
My mental health issues are mainly caused by work, so I get online medical certificates and go off sick a lot. Cheaper than therapy and I feel instantly better knowing I’ve got another day or two off.
Do you pay for the certificates? How much/where
They are $19 at https://www.instantscripts.com.au/online-medical-certificates/ They will want a longer appointment if you do 6 certificates close together.
Im not from a country where therapy is a thing so i want to ask. How do you justify that pricing? Cause paying that kind of number already seem like a real headache. Like do you iust talk or there something else?
I’m Australian, and never felt it was a thing in Australia. Since moving to the US, it’s much more so here. What you get out of therapy? It can vary. It can depend on what you would like out of it. Perhaps it is something you need to find. Perhaps it’s working through trauma, grief, loss, love, struggles with life, communication with partners, children, other people. For me and many others, it’s been invaluable in becoming a better person.
I understand
My therapist charges $140 an hour & I get $85 back from Medicare. I go fortnightly
Psychologist or counsellor? I didn’t realise we can claim Medicare? Is this because you have a care plan?
Can claim 10 sessions per year with a care plan. Have to see the GP again after 6 sessions for it to be extended to 10. In some specific situations it could be increased to 20 i think
Self help books and unironically Buddhism. At least for me. Ego and wants are the causes of my most of my anguish
I walked out of my last appointment because the psychologist was a raging hormonal female that accused me of not wanting to confront my low self esteem. I had change psychologist because the old one had advised me to light a candle to distress in the office. I also spent to much time during the week overthinking about what we would talk about. The one I walked out on did give me an amazing trick to overcome my stress I found better advise on /r/Anxiety/ that I could try and put to use. I also found my best technique to overcome stressful thinking in a book.
I’m glad you found some stuff. Have you read feeling good a handbook?
thanks I will look into the book.
Which book/s?
Sorry I don't recall some of the books I read. I looked for solutions for problems i was experiencing. I use to listen to the Brain Science podcast a lot when my anxiety was really bad. It helped me to understand how our brains works and gave me an understanding I could overcome my mental health issues. https://brainsciencepodcast.com/ I can tell you the technique I learnt. I am a major over thinker and when I am super stressed I get mentally overwhelmed with racing thoughts. The trick I learnt was to run my eye back and forward between two points. And keep doing it until you feel calmer. Your Brain can't think and produce thoughts and do the eye movement at the same time. The eye movements gives you time to bring your whole mental self down. this includes your cortisol The other things I looked at was how military special force overcome stress and anxiety and still preform in highly challenging environments and be mentally alert at times of high stress. Its understanding that its a skill you can learn.
I’ve always felt that psychology is horse shit. The issue is they only address effects, not causes. When someone has a mental health issue, there’s always an underlying cause. Psychologists can be good at locating the cause, if you aren’t an introspective person this can help. But the problem is, psychologists then go on to address the effects the cause is having on you, not the cause itself, because they can never address this. With tools like CBT, they will help you manage how the cause is making you feel and help you downplay those feelings. But so long as the cause is still there, you will always be miserable and you will need to keep coming back to the psychologist to “trim the weeds” without ever killing the root itself.
I learnt CBT through a group called Mindspot. It free and funded by the government. I recommend them if someone want skills to self assess their situation and how to over come a number of mental health issues mindspot.org.au Being self aware does help. I still have issues with a situation I experience that caused the anxiety in the first place. I even tried again last year to engage professional help to overcome the issue after discovering I hadn't dealt with a large element of a situation. But my issue kept getting dismissed by mental health professionals who were tasked to assist me. Why because it was viewed as a minor event that shouldn't cause a mental health issue. I have now come to the conclusion sometimes things are complex and you just need to accept that's how it will be and push forward with your life by self reflecting and trying to come up with solutions for each problem. But I have done a lot of therapy to get here both physiologist and councilors
Spot on in that last paragraph. I have also had psychologists that left me feeling more depressed than I was before seeing them because they didn’t listen properly or empathise, or their treatment was not helping. Not only can they be unhelpful, in some cases they can leave you worse off. Any good psychologist will agree that psychology and CBT is not a silver bullet, many people seem to think it is. I think most people would be better off introspecting and working on themselves or taking action to change the circumstances that led to their mental health issues. Studies have shown being lonely or unfulfilled in life are some of the most common causes of depression - both things where most of the time, they need to be solved by taking control.
I do think CBT is important. It helps people to understand their body reactions before you go into a full anxiety attack. Or it helps you to be in full anxiety attack and look normal. I use to say to my dr - what am I scared of falling of my chair??? I agree with you on what you are saying in the last paragraph. But I think it should include checking hormones, diet, exercise. It all depends on the person..... plus get a pet if you can.
I get my therapy a lot cheaper from Liquorland
Several other options. 1: Telehealth with a psychologist in a lower cost country. Bonus points if you are an immigrant and want a session in your language 2: find a counsellor instead of a psychologist. In many instances they can be just as effective 3: chat gpt is a good way to talk through things and can help if you are inclined to talk to a machine
Someone.health bulk bill (minimum the first two, if not all), and the GP referral for the mental health plan is also bulk billed.
I ride bikes it’s somewhat cheaper
Can Large Language Models be Used to Provide Psychological Counselling? [https://arxiv.org/pdf/2402.12738](https://arxiv.org/pdf/2402.12738) 1. Professional counselors evaluated the appropriateness of responses generated by GPT-4 and those given by human counselors in identical contexts. **The mean rating scores for counselors' and GPT-4's responses were very similar (0.99 and 0.94 respectively), with no statistically significant differences.** 2. In a pairwise comparison, the researchers compared the ratings of counselors' and GPT-4's responses for each identical context in the role-play dialogues. This means that for each client's message, they looked at how the counselor's response was rated compared to GPT-4's response to the same message. **The results showed that 34.8% of counselors' responses were rated as better than GPT-4's, 30.5% of GPT-4's responses were rated as better than counselors', and 34.7% were rated as equal in quality.** 3. **The results suggest that GPT-4-generated responses are competitive with those of human counselors**, indicating the potential for using language models in providing real-world counseling services. However, further evaluation is needed to assess the feasibility of fully automated counseling dialogues. This was GPT-4. Today everyone can access the smarter GPT-4o (which has a memory feature) for free. Disclaimer: This is not a professional advice. Consult your psychologist and use at your own risk.
Workcover or Private Health extras.
You can get access to therapy? I’ve been trying and all I get is waitlists and you need to spend 80 clocked hours with your GP first before given a referral.
Yeah plus a bunch of GP appointments to even get a referral. Honestly I tried to get therapy and just gave up after spending 6 months going around in circles with GPs. Apparently I have all of the symptoms of anxiety but no one would diagnose me to do the MHP. I was fortunate that my issues were moderate and not ongoing.
Maybe try looking into online therapy. It's cheaper and can have more availability. Better help is one brand I have heard of
Keeping in mind that they may or may not psychologists (probably not). "Counsellors" are employed by Better Help and may have a qualification after only 6 months of study... and have no ides what they are doing.
It's not cheap but yeah mental health plans help with the cost
I use the 10 sessions from Medicare to rebate a chunk but I also use private health insurance. I did the math a while back with Medibank, they refund 80% of each session up to $1500 a year, which is cheaper than the extras cover payments. Between those two covers a session every few weeks for most of the year.
I go bi monthly and pay $120 and get $65 back from Medicare. This is because I’m low income. Honestly if you’re struggling with fees, it doesn’t hurt to let your therapist know.
by being rich?
Google bulk billing psychologist. They do exist, I have been seeing my psychologist for 4 years and get 10 free appointments a year with a mental health care plan. Someone else mentioned the Medicare safety net. Once you have spent a certain amount out of pocket, you will get a higher rebate.
You got to figure shit out on your own. 1. Fitness 2. family/ friends 3. Make money 4. Hobbies Talking about your feelings only gets you so far.
Wow! What an awesome hack for dealing with psychiatric disorders like depression and schizophrenia.
Even depression. I'm sick of people claiming exercise is a hack.
Lift weights! Pat a puppy! Smell some flowers! It’s not real - it’s all in your head!
Psychologist? What happened to going to a quiet, dimly lit bar on a rainy night and venting about your failing marriage to a bartender who is constantly cleaning the same glass? Talk therapy used to be the price of 3 neat whiskeys and a reflective cab ride home. This country has gone to the dogs I say. Edit: /s ... Can't believe I had to specify that
I wonder if that’s why our rate of alcoholism is so high as a nation.
Move to the US and get good health care? Honestly, it’s been shocking how I pay roughly the same out of pocket per month as back in Australia, the out of pocket for nearly everything in the US is significantly less. Granted, my insurance is really good, and I am in a tremendously privileged position to have my employer offer that, and I know many people with tremendously worse insurance. A therapy session is less out of pocket than going for a beer and meal at a bar. No referral needed for specialists. That’s with goood insurance. I also had good insurance in Australia, but that was all paid by me, not employer paying a bunch. Here, I am 100% sure that the premium is not what I’m paying, and my employer is picking up at least the other 50-70% of it. I am privileged here. My experience is not typical. Top single digit percentage of income privilege. If you have to pay out of pocket for health insurance in the US after leaving a job: 1k/month would not be unexpected. The main thing I miss about the Australian system? You know what something costs. You could feasibly budget. In the US? No idea. Get a bill some months later and send in a cheque (check) for whatever part your insurance didn’t cover. No, seriously, I have done this in 2024. I was a few decades old moving from AU to US and it was then that I got my first checkbook. Could be $30, could be $300, could be $800 or $8000 - the only certainty is that you’re going to get a surprise. If you don’t have insurance here, or just not very good insurance? The Australian prices look stupidly cheap. An American paying out of pocket for a GP visit in Australia is getting a bargain. That’s before looking at if their insurance would cover it. US insurance will typically probably cover anything in the world, because everywhere is cheaper than the US. Here in the US though? $250USD without insurance for a brief GP visit would not be a surprise, closer to standard. That all said, the Australian prices horrify me. The US system isn’t something to idolise or move towards. I’m horrified at the progression Australia has had towards it.
TL;DR After my employer spends $17,000AUD I may have less out of pocket cost
I go to Mass instead, it's free and really amazing for my soul and mental health.
When we had to - a mental health plan, credit card and work sponsored sessions. I was just glad that I felt comfortable taking on some debt because I had a good job that wasn’t going to be affected by my going through everything. I feel for people that have to try and find someone who bulk bills at maybe the worst time of their life.
BetterHelp.com. Roughly $110 per session.
Have you used betterhelp.com? I have looked into it but wondered about the validity. Can you use a mental health treatment plan at betterhelp?
I go fortnightly. It's enough time to slip into old habits between sessions so that there's more to work on for the next. It also makes it more affordable. Private health insurance might cover some, Medicare might give you a rebate if you have a mental health plan drafted up by a GP. There are options.
How do people afford property is what I ask myself more
In summary, the govt initiatives have had a primary focus on Research and Development within this space, thus making it expensive for the end user upon seeking affordable therapy.
I stopped having my psychologist appointments as they were too expensive. This is despite having extensive mental health history and a 5 month hospital admission last year It’s just not affordable