The Joys of Accessing Psychiatrists and Psychologists in Rural/Urban Australia... a never-ending saga

6 May 2023

I’m Anna: first-time blogger, longtime Moodscope user/mis-user (I’m very bad at doing things daily). 

I first came across Moodscope maybe a decade ago. I was looking for better ways to document my mood ‘iizzooos’, as they say, in particular bucketing treatment-resistant depressions. I was stoked to find a free, easy, evidence-based, research-assisting, more fun to use option - where I didn’t swear at (or reframe and rewrite) every question. And now that I’m a healthcare professional myself, I recommend it to peeps.

Anyhoo, me aside… 

This blogpost is titled ‘The Joys of Accessing Psychiatrists and Psychologists in Rural/Urban Australia... a never-ending saga’.

The title says it all really. TLDR: it’s darn impossible to

I’ve been a ‘psych patient’ since last century. I’ve lived in three locations, rural AND urban, in two states of Australia (including NSW, our biggest, theoretically best serviced state). And I’ve been a professional researcher, looking at rural and urban healthcare divides. Spoiler alert: rural and remote always have worse outcomes. Pretty well any illness, physical or mental. UK too.

And, like most western countries as best I know, most ‘psych patients’ are GP-managed. Primary healthcare. At its best when it keeps everyone out of hospital as much as possible.

But guess what: accessing a psychiatrist outside of hospitals in Australia has always been difficult. Long waitlists. Very expensive. Our beautiful, world-renowned Medicare system is awesome if you are admitted, but darn problematic if you are ‘in the community’. Where we want people to stay.

Because: there’s these things called ‘gap fees’, which are the difference between what government will fund and what your average healthcare professional needs to charge - in order to pay for insurance and business premises. Gap fees (or full fees if you are not eligible for a Medicare rebate) can be $100-300 a pop. I know. I’ve paid them.

And some GP management can be… unmanaged. Or mismanaged. And guess what: GPs are well aware of their professional limitations and skills. Might decide that they want advice, a second opinion – that ‘this is out of basic management range’, ‘not responding to basic meds/psychologist support’… (did I mention how much psychologist appointments cost… or the current length of psychologists’ wait lists… nationwide…)

Anyhoo, your average GP at some point may sensibly want to refer people to a psychiatrist.

At which point, even in a state capital, your wait time can be six months. Or more. Not ideal, if your patient is acutely suicidal. Or gently suicidal. Chronically anxious, complex PTSD, all the usual problems which community treatment can (and should) really help.

But I recently waited 18months for an ‘urgent review’. I couldn’t get ‘my’ interstate telehealth psychiatrist’s input when I got hospitalised months after that request. And it turned out to be viral encephalitis. Which presented rather like psychosis… so the hospital specialists had wanted my psych history. Fair enough. 

And we (all) tried hard to get hold of my psychiatrist, and (whilst I partly blame covid) – well, his wait time/availability was worse than ever. Literally did not respond. He was a bit stunned later when I updated him. He changed my meds. Better late than never.

So any of you psych out there who want to move to Oz… come on down. Psychologists too. And psych nurses. Please. I’ll help you find work!

Until next time - when I’ll attempt to talk about something other than poaching your healthcare professionals.


A Moodscope member

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Moodscope members seek to support each other by sharing their experiences through this blog. Posts and comments on the blog are the personal views of Moodscope members, they are for informational purposes only and do not constitute medical advice.

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