Sarah Beck: Australia shows how to make psychiatric help available to all

Mental health care needs to be truly accessible. Photo / 123RF

Opinion

• Sarah Beck of Northcote is a counselling psychologist.

Imagine a sign outside your local medical centre offering free counselling. Imagine your local medical centre as a one stop shop offering help for both physical and emotional mental health needs.

While you may not be among the one in six New Zealanders needing help for a depressive illness, you may well know someone else who is not getting the help they need because of the cost, the wait time and the fact that there aren't enough weekend and after hours services available.

I was fortunate to work in a one-stop medical centre in an outer Melbourne suburb. Open 24 hours, 7 days a week, the clinic enabled me to see the depressed unemployed or elderly during the day, depressed children and teenagers after school and working parents and families in the evening.

None of my clients paid for counselling. All were referred for anxiety or depression by their GP. I was employed by Medicare, the Australian healthcare system, and was paid a similar rate to an ACC counsellor.

My clinic, being in one of Melbourne's poorer suburbs, also offered access to the Access to Allied Psychological Services programme (ATAPS), an adjunct to Medicare. Introduced in 2001, this programme enables GPs, nurses, hospital emergency departments and school principals to refer the mentally unwell to a range of mental health professions including social workers and psychiatric nurses.

With depression on track to become the second leading cause of disability in the world in three years time, according to the World Health Organisation, the ATAPS programme exists where there are service gaps and populations not well serviced by other mental health programmes.

Aotearoa could benefit from looking at the model which operates in low socio-economic areas targeting children, teenagers and adults at risk of suicide or self-harm. The programme provides up to 18 free sessions of counselling per calendar year for those at risk of suicide.

New Zealand is way ahead of other western countries in providing ACC funding for free counselling sessions for survivors of sexual violence. But the suicidal may wait weeks for help from the public system and the cost of the private system can be prohibitive.

Former Labour leader Andrew Little described the present system of mental health treatment as overstretched, fragmented, lacking effective co-ordination and chronically underfunded. Labour wants people needing help for depression to find the front door more easily to access free services.

I would suggest that the most effective front door is the door to your local medical centre. At the risk of placing even more responsibility on overworked GPs, I believe even small medical centres could open evenings and weekends to make rooms available for counsellors especially when they are given a financial incentive to do so.

Mental health care needs to be truly accessible. What could be more reassuring than the familiar front door of your local doctor? Accessing counselling support when you have almost given up on life needs to be as effortless as walking into a McDonald's.

And if New Zealand can be a world leader in its counselling support for victims of sexual abuse, there is no excuse why it cannot provide free and widely available counselling support for depressive illness.

Surely it is as simple as finding the will, finding the money and tackling the inflexibility of some of the present providers.

WHERE TO GET HELP:

If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.

OR IF YOU NEED TO TALK TO SOMEONE ELSE:

• LIFELINE: 0800 543 354 (available 24/7)
• SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757