Culture

What Happens When U R Not OK? It’s Time For Australia’s Next Steps On Mental Health

Awareness is great! But it's not enough.

It’s been a hard slog, but it seems like Australia is finally getting the message when it comes to mental health. Mental Health Week, R U OK? Day, World Suicide Prevention Day, and ABC’s Mental As campaign all continue to grow each year. We’ve laid down our tall poppies and are welcoming the conversation with open arms, ready to talk about what’s really happening — and what needs to be done. The invisible is becoming visible. It’s bloody good, really.

But, despite all the campaigns and research and conversation, there’s still a glaring problem: for many, it’s still incredibly difficult to actually access help. The stigma is slowly being smashed and politicians are occasionally sitting up to take notice, but the frameworks of the organisations and services that provide help are groaning under the weight of the hundreds of people desperately knocking on their doors.

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Anyone who has ever accessed mental health services knows that the road to getting help can be fraught with bureaucratic rubbish and a whole lotta cash — and that’s all if you already know how and where to find help.

The Wrong Time For Struggle

It took me over five months to access a therapist this year. A frustrating concoction of waiting lists, a lack of funds, and therapists who just didn’t work for me contributed to that time, and let me tell you, it was a time when I could have really used the help.

Still, I’m much luckier than some. My mental health issues do not usually sit at the severe end of the chart, and most days, I’m able to manage. I have a supportive family and partner, and I’m usually armed with the basic tools that I personally need to get through bad periods. Though my financial situation is nothing short of a nightmare, if I needed money — and wasn’t too damn proud to ask for it — I could get help from my loved ones.

But that privilege doesn’t make the waiting easier. It doesn’t make the phone calls and paperwork any less of an anxious exercise, and it doesn’t stop the gut-sinking feeling that I shouldn’t have to push so hard to get help at a time when I need it most.

Why is it still so hard? Why is it still so expensive? And why does the system seem to be structured to only benefit those in privileged positions?

A Bandaid Solution

Some areas of the mental health system are working quite well. If you need immediate assistance — if you are thinking about taking your own life, or are in a particularly dangerous headspace — there are several avenues to go down. Hotlines like Lifeline are available 24/7, drop-in centres in major cities can provide immediate help, and you can call an ambulance or head to the nearest emergency room.

Those services are all incredibly vital and appreciated, and yet, for many they simply act as a bandaid slapped across the inner workings of the brain, ready to peel off at any minute. They are the immediate fix, and often come with no contingency plan for what comes next. This is our mental health system’s biggest flaw: an inability to provide easy access to ongoing help and prevention.

Mental Health Australia is the peak independent body representing mental health services in Australia. Their reports and calls to action to sitting governments consistently include the same recommendations: an increased investment in early intervention and ongoing prevention, and the need to improve access and choice to the system for those dealing with mental health issues and their carers. Sounds simple, right?

But one of the biggest barriers to treatment is access to funds. It isn’t cheap to look after whatever is going on in your brain. And though recent initiatives like Mental Health Treatment Plans have made things slightly easier, they are rife with hoops to jump through and still require a big dip into the savings. If you do end up in a situation where you can get a rebate, you’ll likely receive a maximum 8-10 rebated sessions per year.

For some, that might be enough; for others, it might not even crack the surface. Those sessions are rarely free or even cheap; there’s often a considerable gap to fork out depending on the service you’re using. My current gap per session is around the $45 mark, and that makes me one of the lucky ones — you could face a few hundred bucks each session for specialist services.

And it’s not just the individual session payments that burn a hole in your pocket, it’s all the extras as well. The GP appointments if you’re on a Mental Health plan, the medication if you need it, the cash or fuel to get to the sessions, and the funds you might waste on providers who don’t fit your needs before you find the right person. It’s an expensive exercise — but why?

We Need Smarter Government Investment

Towards the end of 2015, the federal government announced a massive overhaul for the mental health system — but no extra funding. Mental Health Australia CEO Frank Quinlan says that this lack of investment is a big kick to the guts.

“Unlike other areas of substantial government reform, governments have not yet invested adequately in change management to achieve these mental health reforms — to their detriment,” Quinlan says. “Unless there is adequate investment, there is a real risk of unintentionally removing access to services for some consumers and carers.”

Quinlan confirms that the mental health system is ready and calling out for change and reform, but without the funding and support to do so, they’re left struggling to keep up. It seems that the effects of stagnant funding are already being felt across the country. Within the past month, it’s been reported that the Northern Territory’s Lifeline service has been forced to shut its doors, thousands have been shut out of the NDIS in the ACT, and the NT is in crisis without the services provided elsewhere. And that’s just the tip of the iceberg.

When it comes to any service designed to improve our general quality of life, it’s always the most vulnerable that fall through the cracks. New research released by headspace shows that 50 percent of young Australians are waiting up to six months to access help for mental health issues, many citing financial concerns as their top reason.

Our national suicide rate is at its highest in a decade, and many Indigenous people, particularly in remote areas, are at crisis point. The NDIS is shaping up to be messy and mishandled. Both onshore and off-, refugees and asylum seekers are experiencing mental health pressures that many of us can’t comprehend. Services are either not reaching those who need them, or aren’t providing enough — or adequate — care.

It’s easy to be critical, and I don’t have all the solutions. But, education, early prevention and easy access to ongoing care seem like a good start. And yet, with a government that seems to be all talk and little action, it’s difficult to feel hopeful.

The campaigns around mental health are firm in telling us that our care is in our hands. At the end of the day, our mental health is our own responsibility — and in a sense, that’s true. But how can we help ourselves when the tools and services to do so seem so far out of reach? How can we care for our mental health when seeking help sometimes seems like more trouble than it’s worth? When the journey to getting help is so demanding, it can be difficult to dig out of the dark. It’s not good enough.

If you’d like to talk about any issues with your mental health and options getting long-term help, you can reach Lifeline on 13 11 14, or beyondblue on 1300 22 4636.

Chloe Papas is a journalist and writer based in Victoria. You can find her on Twitter @chloepapas.

Feature image via beyondblue.