Mental Health Care in NSW for cheap?
August 4, 2010 1:02 AM   Subscribe

Advice needed for my 20yo sister regarding psychiatrists / psychologists, or some combination of the two, for as-close-to-zero-dollars as possible, in Sydney. Preferably after-hours or weekends.

My younger sister has moderate-to-severe depression (suspected to be some form of bipolar but uncertain) and has had it since she was very young. It may be a more complicated problem, it seems like there may be some comorbidity.

She is finally getting to an age where she is more willing to see specialists (despite not having much faith they will help her); however she is obsessed with not spending money, which makes it hard. She refuses to spend $360/hr on a psychiatrist.

A relative has kindly offered to pay for an initial consultation. This is great, except that I doubt one consultation will be enough to get to the bottom of such a long-standing problem, not to mention the fact that it is very unlikely the psychiatrist will get any particular combo & dosage of drugs absolutely right after the first visit.

I can almost guarantee that my sister will not be willing to spend $360 on the second consultation, especially if any drugs prescribed have had negative or unnoticeable effects on her depression. Thus she is likely to lose faith in treatment again.

What can we do? Is it possible to set up some system where she sees a bulk-billing or cheap psychologist in between visits to the expensive psychiatrist?
I envision my sister being monitored by a psychologist every 2-4 weeks, and then this psychologist being able to communicate with the psychiatrist, necessitating a $360/hr visit only every few months or more rarely. Does this type of thing happen?

Please help, any advice welcome.

My sister works full-time and it is very difficult for her to make appointments during work hours so an after hours clinic or one that opens on weekends is ideal, but I do welcome cheap clinics with regular business hours as well. She lives in Frenchs Forest but is able to travel.
posted by KLF to Health & Fitness (6 answers total) 1 user marked this as a favorite
No specific recommendations, but some general advice in terms of financing this stuff.

These days, psychologists are covered by Medicare if you get a treatment plan from your GP. So that should be her first step. She will get something like 10 sessions covered - some psychologists will bulk bill under this sort of plan (regardless, to be covered by Medicare, the psychologist needs to be registered to provide Medicare services). The GP may have a recommendation. This page might give you a better idea of what she can have covered. I am not so clear on details for psychiatrists, but hopefully she can talk to her GP about this.
posted by AnnaRat at 2:06 AM on August 4, 2010

The first step will be to get her to a GP: they will be able to give her a referral to a psychologist. This is essential in order for her to be eligible for the medicare rebate for mental health services. This will cover approximately half the cost of a session with a psychologist, but she will still be out around $75 for each visit. The rebate is good for up to 12 visits a year *I think*

The psychologist will not be able to prescribe anything for her, but would be able to give advice to the GP, who can, this may be a good first step while a psychiatrist is found. The psychologist may also have a better idea of a suitable psychiatrist. No psychiatrists that I am aware of will bulk bill, but a good portion of the fee can be claimed back as a rebate from medicare. Some psychologists will bulk bill, but I have had dubious experiences with that.

I am so sorry to hear that your sister is having such a hard time. I have some experience with psychologists and psychiatrists in the Sydney area, please feel free to memail me if you need more information.
posted by arha at 2:08 AM on August 4, 2010

Ditto on the medicare option. Most GP's are able to provide a very good referral.

Also there are a range of govt funded youth services that provide psych services. Look up "headspace", , or your local youth service for localised advice (your local council should have a youth officer who can help). Also there is a place called Youthblock based in camperdown, they are a youth health service- i'm sure they can point you in the right direction too.

If that doesn't help, send me an email: i've worked in the NSW youth sector and may be able to track down some more info.

Take care.
posted by MT at 3:05 AM on August 4, 2010

From a MeFite who would prefer to remain anonymous:
Your sister can get the care she needs without paying any money at all. Here's what she needs to do:

Step 1) Call 9351 0672 and make an appointment with a psychiatrist at the Brain and Mind Research Institute's Clinical Centre. Tell them she'll bring a referral from her GP.

Step 2) Visit her GP and ask them to set up a Mental Health Care Plan. This entitles her to 12 Medicare-funded sessions with a clinical psychologist per year - up to 18 if her GP agrees. In addition to these appointments, she can attend up to 12 Medicare-funded group therapy sessions and five sessions with an accredited personal trainer at her local gym.

Step 3) Ask the GP for two referrals: One to the psychiatrist at the BMRI with whom she already has an appointment, and one to a a clinical psychologist who bulk bills - the GP will have a list.

Step 4) See the psychiatrist at BMRI, and see the clinical psychologist her GP referred her to. Make sure they both have the name of her GP, who will probably end up coordinating her mental health care over the long term.

The psychiatrists at the BMRI will definitely bulk-bill. The setup is welcoming and very professional; it doesn't have a miserable 'free clinic' vibe at all. If your sister can't get convenient appointments with a bulk-billing clinical psychologist, she'll need to pay the difference between the psychologist's fee and the Medicare rebate of $117.65. If she doesn't currently have a bulk-billing GP, she might want to look at the clinics attached to Sydney's various universities - many of them bulk-bill even for people who aren't students.

Alternatively, because your sister is under 25, she is eligible to receive care at one of Sydney's three Headspace centres. These deal solely with youth mental health and are completely free (government-funded). Headspace centres have social workers, psychologists and psychiatrists all working under the same roof, so they'll be able to provide the sort of coordinated care it sounds like your sister needs.
posted by jessamyn at 6:02 AM on August 4, 2010

Sydney Uni provide cheap psychological (so, no drugs) therapy sessions for the general public, as cheap as $10 a session.

The CADE clinic at Sydney Uni might also be an avenue to explore for treatment options, although I have no idea of their pricing.
posted by robotot at 3:18 PM on August 4, 2010

A bit late to the show, but you could try calling the Black Dog Institute (link to the depression clinic) - I used to see none other than the Executive Director, Professor Gordon Parker, and he bulk billed. The Frenchs Forest area should also have something equivalent to the government-run Marrickville Community Mental Health Centre, which offers a range of psychologist & psychiatrist services, also bulk billed (from memory).
posted by UbuRoivas at 9:55 AM on January 12, 2011

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