What makes a psychologist reach for a drink

The last couple of weeks I’ve been busy letting it be known to the politicians that I’m unhappy about the changes that they are about to make to Medicare in relation to psychology. I don’t usually get involved in anything political but this has direct implications for most of you so I felt I had to.

The whole thing is very frustrating and disappointing.

One of the proposed changes that is going to impact you is that the number of sessions that you can receive with a Medicare rebate will from November be cut down from 12 (with the possibility of 6 more in “exceptional circumstances” so in reality 18 sessions) to 10 per year. No possibility for additional sessions under any circumstances. What? Are you feeling upset and wanting to jump off a bridge? We sympathise, but sorry no additional sessions under Medicare. Are you feeling overwhelmed after years of sexual or physical abuse? We are truly sorry but – no extra sessions for you either. Did you say that you often lose your temper and bash your partner and kids? That’s not good – but we really can’t give you extra psychological help although that would probably help.

I don’t know where the number 10 comes from. It seems arbitrary as none of the research that I’ve come across seems to suggest this particular number – especially not with people who have been struggling with their problems for a while. Most of you that I’m working with have had your problems for months if not years before you get the courage/time/incentive/money/whatever to come and see me. Some of you require 10 sessions or less but many of you require more.

Naively, I believed that the policy makers (based on the research evaluating the treatment patients receive under Medicare) would have recognised that the current system actually works in getting affordable psychological care to people. The GPs seemed happy because they are able to refer depressed or anxious patients to appropriate treatment and patients were happy because whatever problem they presented with was now finally addressed and treated. The only ones not happy appear to be the politicians.

Under the new Medicare scheme, instead of seeing a psychologist, the government suggest that you: 1) go to your local mental health centre or 2) see a private psychiatrist. These two suggestions do not make sense to me: As some of you know, I also work in a mental health centre and therefore know first-hand that these centres are generally under-staffed and over-stressed so your chances of receiving prompt psychological services there are slim. Furthermore, there are not enough psychiatrists around to fill the gap left by psychology and many psychiatrists do not even do psychotherapy but specialise in prescribing medication for mental problems.

It just seems such a shame to mess with something that actually works…

Last week I had to stay home for a couple of days with my son who was sick with whatever it is that is making everyone sick at the moment. At my job at the community mental health centre I was subsequently told that I needed a doctor’s certificate. But – I argued in what I believed what a perfectly reasonable manner – I didn’t go to the doctor. My child was sick and needed rest – not to sit and wait in a surgery for an hour and he was contagious and there was no reason to pass on the bug to everyone in the waiting room. And the doctor would have just told me to take him home to rest. No, came the answer from the HR department, you need a doctor’s certificate.

Right.

On the same day I received an email from the same HR department proudly announcing that we now have a new form of leave – domestic violence leave. And you don’t need a doctor’s certificate for that! No shame and humiliation in claming that leave, right?

So, I can’t stay home with my sick kid without a certificate but if I can get my partner to throw me against the wall and get a few bruises it’s okay….

Madness.

Forgive me for being a little cynical this week – it’ll pass.

It always does.