It's Not Just About Hotlines

Content note: this article mentions suicide

You’ve likely heard about Anthony Bourdain, Kate Spade, and Avicii’s deaths in the news. Once again, certain media outlets have released details that are unsafe to broadcast to the general public. I’m very sorry if you’ve come across these details and they’ve made things worse for you.

Suicide hotlines provide an important service, which is why you’ll see one at the bottom of this article – but they’re not everything. Scrolling through social media to find people suggesting that everyone from their inner circle to peripheral acquaintances should call these numbers to “get help” can feel very… detached.

These services can be extremely useful in times of crisis or despair, but you are also a resource – and if your help is what’s on offer, more tangible gestures will make that help easier for the unwell people in your life to accept as a genuine invitation.

You cannot – and should not – hold yourself responsible for providing the level of help a mental health professional can. But if someone you know is struggling, there’s something you can do that a mental health professional can’t: you can show up as a friend.

Everyday invitations like: Do you want to have dinner at my place? Do you want to go for a walk? Do you want me to come to you? are more valuable than you might realise. If the person declines, the offer is not for naught; they'll know you were thinking of them. This is the difference between a warm exchange, and a well intentioned, but diffused one. Social media isn’t new, but we’re still trying to work out how to use it thoughtfully.

If you know someone who has died by suicide, you are not responsible. If you offered this kind of help, and feel it didn’t make a difference – it did. A freeing but sometimes sad truth about other people is that we cannot control what they do. All we can offer is genuine connection, and hope that it’s enough to hold onto. Worrying about another person's mental health can be distressing, so if you’re making yourself available to others, don’t forget to care for yourself in the process. 

Finally, if you’re struggling and aren’t able to seek help right now, that’s ok. Help-seeking requires energy. Consider making an emergency plan, and do all the nurturing or soothing things you can think of in the meantime. Even if they're passive – just be as good to yourself as you can manage. 

If you need to talk to someone about suicidal feelings or have lost someone to suicide, please call The Suicide Call Back Service (1300 659 467). For immediate help, please call 000. If living outside of Australia, please seek out services in your country. 

See also: Accessing Mental Health Services, When We Talk About Suicide

Image credit: Stranger Things, Netflix.

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Accessing Mental Health Services

Accessing mental health services can feel overwhelming; we might lack the energy required for research, or the ambiguity of it all might make us feel like we're not supposed to ask. Below you’ll find information about some of the ways you can access help, and what to expect when you do.

These programs are not perfect – the limits on sessions and gap payments in particular are often barriers for people, but it’s important to know what services are already in place. If you’re concerned about these limitations, please contact your local, state and federal members of parliament about creating better policy. You may also want to use awareness raising days (such as R U OK? Day) to draw attention to these financial barriers. We all deserve equal access to mental health services. 

As always, the best person to speak to about your mental health is your GP.

Some helpful definitions

A Counsellor is someone who helps their clients work through life issues with talk-therapy. You might see a counsellor to help you process feelings of grief or anxiety, or to help you with communication issues, life transitions etc. Counselling is best suited to short-term help.

A Psychologist is an expert in human behaviour. They either have a Master’s Degree or PhD, and are able to use their training to treat mental health issues using evidence based therapies and interventions, including talk therapy. They cannot prescribe medication.

A Psychiatrist is a medical doctor with a postgraduate qualification in psychiatric care. A GP can prescribe some anti-depressants/anti-anxiety medications, but psychiatrists are able to help people tackle more chemically complex issues like bipolar disorder or psychosis. They typically don’t include talk therapy as part of their ongoing services.

Via your GP (Better Access Initiative)

You can access 10 Medicare rebated sessions with a registered psychologist (per calendar year) via a Mental Health Care Plan. 

How do I get one, and what can I expect?

• Book a double appointment with your GP; these visits can sometimes take longer than the standard time slot.

• Your GP will ask you a few questions about what you’re experiencing, and likely take you through the K10 test (Kessler Psychological Distress Scale). You can take the questionnaire on the Beyond Blue website to see what it’s like.

• They’ll provide you with a letter of referral, addressed to a psychologist in your local area*. Once you have this, you can go ahead and make your first appointment.

• This referral allows you immediate access to the first six sessions; access to the remaining four requires a follow up appointment with your GP.

• Depending on your history and circumstances, your GP may flag the idea of using medication to manage your mental health. Medication is a useful tool for many people.

• You can claim your rebate by using the Medicare Express Plus App (Apple, Android).

• You don’t need a referral to see a psychologist, but you do need one to access the rebates. For more information, see the Australian Psychological Society Medicare Fact Sheet.

• A healthy, safe, therapeutic relationship with your psychologist plays a pivotal role in whether or not therapy is helpful. If your current psychologist doesn't provide that for you, you can absolutely change to a different one.

Find a Psychologist™ *

Your GP will recommend a psychologist for you, but if you want to have greater control over who you see, you can search the Australia Psychological Society’s tool, Find a Psychologist™. There, you can read people’s professional biographies, areas of specialisation, how to best contact them, Medicare status etc. If you think you’ve found a good fit, bring their details along to your GP appointment.

Via your workplace

If your workplace has an Employee Assistance Program, you can access a limited amount of free counselling sessions through the organisation they've partnered with. These sessions are confidential, and don't have to be used for work-related issues. If your workplace doesn't have an EAP (and you feel up to advocating), you may want to use this as an opportunity to push for one.

Important caveat here – having an EAP doesn't automatically make a workplace mentally healthy or sustainable. Sometimes these programs are used to give the illusion of care. Come work for us! We have an EAP, and a pilates class and a staff pool table – but don't forget to work all the time and abandon your family, friends and hobbies because work is life. 

To accurately take the temperature on this one, take a look at the conditions under which people are expected to work. What's the staff turnover rate? Are requests for flexible working arrangements met with distrust? Do staff treat each other with respect, regardless of title? Is overtime recorded in any offical way, and are staff allowed to use it as TIL (time in lieu)? 

An EAP can be really helpful, but it can't fix a poor environment. 

Via a Headspace Centre

If you’re under 25, you can access counsellors, psychologists and psychiatrists for free/low cost through your local Headspace Centre (they also provide free online services). Most centres are located in densely populated areas, but they do have regional centres as well.  

Via a Primary Health Network (GP referral)

Funding for accessible/complex mental health services has recently been placed with Primary Health Networks, rather than distributed across individual organisations.

• There are six Primary Health Networks in Victoria. You can find your local PHN and their contact details using this map.

• To find out more about the available services and eligibility requirements, please speak with your GP. You can also contact the PHN directly (some programs can be accessed via self-referral).

• With the exception of programs focused on suicidality, these services are aimed at those who are otherwise unable to pay the full fees or the gap payment required for the 10 Medicare rebated sessions above. They provide people with free access to counsellors, psychologists, psychiatrists, social workers etc. for a set amount of sessions, depending on the program.

• As an example, here are some of the services provided by Eastern Melbourne’s PHN (see the Client Information Sheets).

• The programs and terminology vary from PHN to PHN.

Via online or phone support services

See this list from the Victoria State Government to find an appropriate (national) service.

See also: Podcasts About Mental Health, Comics About Mental Health; Reading Between The Lines; Effective Advocacy; When We Talk About Suicide

If you need support, please call Lifeline (13 11 14) or Beyond Blue (1300 22 4636). If living outside of Australia, please seek out services in your country.

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