By Kerry Martin Millan
This post contains descriptions of mental health crisis, mention of emotional breakdowns.
Yep, I’m one of the privileged ones. I was able to spend $1000 on a private ADHD assessment to expedite access to specialist psychiatric services, because I can just afford it. It took two hour-long sessions at $500 apiece. This is only after getting rebates, repeating my medical history, and rushing through an ADHD questionnaire that said I don’t have it. I’m still questioning my diagnosis. Yet, in light of my experience, I can see how a burgeoning wait for psychiatrists could be mitigated in many ways.
According to the ABC, those accessing psychiatric services are experiencing dangerously long wait times. Health professionals are forced to prioritise equally compelling mental health cases in casualty departments, with many health staff burnt out, or even experiencing mental illness from relentless workloads: https://www.abc.net.au/news/2022-12-06/healthcare-workers-mental-health-crisis/101542098
Compounding factors of the health system seem to exacerbate this crisis, perhaps even create it. I don’t blame health professionals. I blame the terribly protracted process that people must transcend in order to receive a diagnosis, which often requires a second opinion.
For a start, I can’t access a bulk billing doctor who can assess anyone for ADHD, nor administer medication. I’m forced to access unsubsidised specialist care in order to prove or disprove neurodiversity. While universities such as The University of Melbourne provide cheaper assessments, the waiting list is now up to 18 months and the price is still relatively high, at around $450 per assessment. As reported by the ABC, many people cannot afford health treatment either.
Sure, a lay person doesn’t have specialist expertise. Yet while I’m not denying or advocating self-help, even the general public has an immense awareness about a range of mental illnesses, thanks to informative mental health magazines. Doctors are further knowledgeable about psychiatry. So, they could make an assessment according to patient symptoms, the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders) and various other strategies, perhaps even temporarily while this crisis abates.
One of the mantras against this strategy is that doctors have no time. The only reason lack of time is an issue is partly due to a lack of access to a patient’s health information. My psychiatrist was unable to access my old health records, nor was I. This is because health records are considered obsolete after seven years.
I’ve had issues with accessing my health records before, when a medical centre perennially promised delivery yet no one was able to access these former health records, because the medical centre was being shut down. Why, I’m not sure.
I refuse to use My Health Record to help with record integration as it allows many different organisations to peruse my health information, not just medical health professionals. If this legislation were changed, I’d use this system immediately.
Regardless, we are in the era of telehealth, Zoom and various other technologies. If health records were accessed more easily from a medical stance, these booming technologies could shorten appointment times, therefore freeing psychiatrists to see more people and possibly reducing costs for patients. Currently, it’s making no difference. My specialist appointments still comprised of two hour-long sessions, where I largely repeated myself.
I believe that behind these protracted policies is the fear that the lucrative careers of specialists will be made redundant if there’s no longer such a need. Yet there will always be a need. Those just about ready to be seen and complicated cases could still be left to specialists, with a backlog still pending. As mentioned, their skills could be used in a more efficient manner. In the meantime, patients and health professionals alike are suffering.
As for the fear of medical malpractice, I believe that no matter the medical supervision, wellness still entails risk. I’ll never forget the time I took Prozac. It wasn’t the doctor’s fault; it wasn’t my fault for asking for something touted as a ‘wonder drug’. Within days I was smashing things and throwing objects, so I came off it immediately. Similarly, my experience with side effects of Ritalin many years ago was exceedingly awful and humiliating because people thought I’d taken illicit drugs. Unfortunately, it’s part and parcel.
Fearing malpractice or blunders is one thing, but when this health rhetoric is adding to it, I say we should stop. What concerns me right now are the consequences of people not being able to access treatment, together with the added costs as more doctors leave the profession in response to dwindling bulk billing services. I’m ostensibly one of the lucky ones. What about someone who’s not?
Kerry is a freelance writer from regional Australia. She writes about mental illness from an intersectional perspective. Her work has been published in Australia and America.
