Guardian Australia asked readers to share their experiences with the mental health system. In more than 700 responses we heard from those suffering from mental health issues, their families and friends, as well as the professionals working in the field, including GPs, psychiatrists, psychologists, social workers and policymakers.
A number of themes emerged from the replies, including waiting times, cost, the inadequacies of care and resources on offer and the impact of broader societal issues such as poverty and abuse.
‘The mental health system can’t cope with the demand’
Every respondent had issues accessing help in some capacity. The wait times to see a psychologist varied from weeks to more than a year. People presenting at the emergency department often have to wait hours. The shortage of beds in mental wards means only the most acute cases get treatment.
“At the height of the Covid lockdown, my son became actively suicidal and incredibly distressed. We called an ambulance. He was taken to hospital … We were there for five hours when they said he wasn’t bad enough to hospitalise.” Kathryn, Melbourne, Victoria
“I am currently not supported by a psychologist because the last one told me there was nothing more she could do for me, and could not find anyone with the expertise to help me who had openings … I have called the Crisis Team for mental health at the local hospital on two occasions. I did not get through to a person on either occasion. No one ever called me back.” Anonymous
“When you’re so low that suicide is a rational and logical step to solving your pain, it’s hard to keep facing roadblocks and pushing yourself to make sure the public system is doing what it was designed for. You are your only advocate and it becomes easy to once again feel isolated, to feel it’s not worth continuing to fight for survival, to feel that you have no value.” Adam, Mount Druitt, New South Wales
‘I chose paying my bills over my mental wellbeing’
“I couldn’t afford a psychologist. Ten rebated Medicare sessions were offered, however I was still out of pocket $80-$100 per session which I couldn’t afford and 10 were not enough. Eventually four years ago I had a breakdown.” Rachael, Bendigo, Victoria
“I chose paying my bills over my mental wellbeing.” Anonymous
“The single greatest impediment to mental health treatment is cost.” Anonymous
“Accessing a psychologist was difficult. Not only was it hard to find someone with availability, but I often had to give up paid work hours (sometimes an entire day of work) in order to make it to appointments, which almost always felt too short, only to have to wait another month or more for the next appointment. Additionally the costs, even after Medicare rebates, were substantial.” IT worker, 37, regional Victoria
‘I cannot even begin to address the huge deficits in the system’
Even once people get access to help, Guardian readers said treatment was often inadequate.
“We feel my son has been put in the too hard basket, as he didn’t get improvement from the antidepressant. We found Headspace more than useless, the hospital system abusive and the private psychiatrist nice but not really helping, and extremely expensive. We are sticking with the psychiatrist because at least it is consistent. We feel we are just trying to keep him alive until we can get some more help.” Kathryn , Melbourne
“I’ve been told by support such as Crisis Assessment Teams that my client was either ‘too high needs’ or ‘not high enough needs’ for them to take on, prompting me to ask ‘what special Goldilocks amount of high needs do they require?’” Anonymous psychologist
“When a crisis happens and he was hospitalised his immediate symptoms were treated and he was then released. But ongoing outreach support was not there.” Stephanie, Newcastle, NSW
“In addition to my daughter’s mental health, my own life has been on hold, stuck in ‘carer’ role, for many years, with an indefinite period ahead of me. It is two lives being wasted.” Anonymous
‘Experience of mental health services can be deeply traumatic’
“It appears to me that the psychiatric system is largely iatrogenic, creating more problems than it helps.” Dr James Alexander, psychologist, Lismore, NSW
“My son at 21 developed schizophrenia … He was then placed in a neuropsychiatric ward for eight months. He went into the ward a very verbal, alert, engaged person. His drug intake was increased regularly, he had 22 sessions of ECT and he became non-verbal, incontinent and almost catatonic. We pulled him out of hospital because we were told that nothing could be done for him.” Stephanie, Newcastle
“In case after case of suicide of mental health inpatients (that actually reach coronial inquest) it is found that nursing staff are not adhering to mandatory observation protocols of patients at risk … my brother … took his own life while an inpatient. In this case he was supposed to be observed every 30 minutes and was not observed for at least 95 minutes.” Steve, Margate, Queensland
“The mental health system, for the most part, made me more unsafe. For almost a decade, my trauma was an afterthought. For almost a decade, no one offered specific trauma treatment.” Anonymous
“My experience of the mental health system in my opinion has destroyed my human potential. Without a private psychiatrist, I don’t know what would have happened to me. Not everyone can afford one.” Kate, Newcastle
“The experience at the hospital was not helpful but it was not as hurtful as what followed. I was released to a ‘recovery’ facility run by a large mental health service provider and that experience was humiliating and retraumatising, although I know my experience was minimal compared to others. I understand the morning calls were made to check on patients, however, they felt intrusive and the person at the other end of the line always sounded irritated by my anxiety.” Anonymous, Melbourne
‘I was trapped in a cycle’
Many responses revealed the way in which society’s broader systemic issues, such as poverty, intersect with and contribute to bad mental health.
“Even providing an excellent service, how do you support good mental health in a young person when their circumstances are not compatible with good mental health? Sometimes I wish I could give the young people I work with entirely new lives and circumstances, because their experience of abuse, poverty, homelessness and punishment from systems like Centrelink are simply not compatible with good mental health.” Anonymous, rural Australia
“People affected are too often unable to maintain their housing rent, bills as well as self care, and just seem to fall between the cracks when the tenancy fails. Asking family to care for them is often just too great of a burden. Often, the person ends up sleeping rough for long periods. Many times, they fall foul of the criminal justice system.” Anonymous
“In a time where government ministers grant themselves time off work with access to the very best psychiatric support whenever they get caught in yet another scandal, it’s particularly galling to be abandoned by the mental health system when I have committed no crime other than to be poor … At least I can – just – afford my medication. Those on jobseeker can’t, and their failing mental health will inevitably lead to more unnecessary sanctions, more unnecessary homelessness, and more unnecessary deaths.” Neil, Balmain, NSW
‘There is a looming crisis’
Professionals have said demand for their services has skyrocketed since Covid-19 began. Yet the system is unable to meet their demands.
“It has always been difficult to access timely mental health care for my patients. But right now it’s the worst it’s ever been – both public and private sector. The system is overstretched and mostly only able to deal with crisis. Also, staff within the system are burnt out, which affects their capacity to provide consistent care. Absence and turnover rates within the sector are high. Unfortunately, people get sicker because of lack of access to specialist support, it takes a crisis to get seen, and once the crisis is past, there is little capacity for ongoing treatment.” Anna, GP, Hobart, Tasmania
“Since the Covid-19 pandemic hit last year, the demand on my service and other psychologists has skyrocketed. Personally I am beginning to notice signs of burnout as I have been trying to accommodate increasing demands as much as I can.” Anna Mills, psychologist, Fremantle, Western Australia
“The dental system is more proactive than the mental health system, and at least we can go for a check-up once a year. I think a regular mental health check-up would be a great thing.” Richard, psychologist, Newcastle
“We don’t need another government inquiry or another report, another apology for failures without any real commitment. The Australian mental health system needs real reform and investment, as do many areas of how we, as a public, care for the vulnerable.” Sandra Hanna, Sydney, NSW
“Public patients have to be actively suicidal to get a bed. The Crisis Assessment Teams are great, but they are under resourced and underfunded. Even if the patient gets into a public service, there is crisis care, then a referral back to the GP or recommendation to see a private psychiatrist. Many cannot afford to see a private psychiatrist even with Medicare item numbers requesting just a one-off visit for a management plan. A lot of psychiatrists are deciding not to do these assessments using these item numbers anyway. We find some private psychiatrists picking and choosing patients. If it seems too hard, they won’t see the patient. This occurs in other specialties too, but seems particularly prevalent in psychiatry. The system is broken. Anonymous GP, Melbourne
Contributions have been edited for length and clarity.