Psychiatry in Canberra.

Myself 7 May 2009 70

Why is it that there are no bulk billing psychiatrists in canberra any more?

Mine has just decided to go from $0.00 to $200.00 just to write a script.

What concerns me is the unavailability of psychiatric care for people other than the rich or extremely poor.

Upset…..


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hmmm hmmm 10:21 pm 09 Sep 10

Oh, and $200 would be BEFORE the Medicare rebate, unless you’re not an Australian citizen/have the appropriate visa etc.
It is a shame that you had to pay this upfront – lots of people just need to pay the gap.

hmmm hmmm 10:19 pm 09 Sep 10

Wickerman, you are a moron.
You have no idea what Psychiatrists do.
I really hope that you never have a mental illness, and need the help of a Psychiatrist. You would be a nightmare to treat.
To the “GP” – you must be an AMAZING GP to not need to refer to Psychiatrists. I wonder if you do all your own surgery, pathology and radiology yourself, too. I also wonder why Psychiatric training is 5 years long (as a bare minimum), and GP training is only 2 years… may reflect knowledge base???
Just so you know, Psychiatrists are REAL doctors (hence the Dr in front of their names), and do order blood tests, CTs, MRIs, EEGs to help diagnose disorders. And they don’t need their GP friends to help them interpret the results.
Sounds like Canberra’s mental health system is strained due to the huge amount of workload, and minimal funding from the government. It is the same everywhere, unfortunately.

jdmal jdmal 1:31 pm 07 Sep 10

You may be able to see a psychiatrist for free through A.C.T Mental Health.

Bosworth Bosworth 12:43 pm 07 Sep 10

do a google search for “carmel underwood”

Pommy bastard Pommy bastard 11:34 am 07 Sep 10

wickerman said :

I wonder how many patients end up at a psychiatrist because medicine couldnt find any pathology, ie, how many people in chronic pain or chronic fatigue syndrome. People also forget it wasnt that long ago ladies who complained too loudly about PMT were referred for psychiatric evaluation. Same thing goes on today but for different complaints.

I wonder how many of these people were diagnosed correctly and gained treatment and advice for their condition from a psychiatrist? I know my sister who suffers chronic pain has had little relief other than the coping strategies and calmative medication she got from a psychiatrist.

Your idiotic bias against psychiatry shines through.

wickerman wickerman 10:51 am 07 Sep 10

Antagonist said :

Wickerman: everything you have presented here is based on hearsay. Nothing relates to your own first hand experiences with psychiatry. You say you are not, but you sure sound like every other crackpot Scientologist I have met.

With love and sloppy kisses. Your local ‘suppressive person’.

Sorry i sound like a scientologist but I am not. I have no interest in that sought of thing. If people are happy with their psychiatrist experience that is good and how it should be.

I wonder how many patients end up at a psychiatrist because medicine couldnt find any pathology, ie, how many people in chronic pain or chronic fatigue syndrome. People also forget it wasnt that long ago ladies who complained too loudly about PMT were referred for psychiatric evaluation. Same thing goes on today but for different complaints.

I wasnt commenting on just on hearsay. Think about the money that is made from drugs and expensive consultations. Theres no diagnostic tests. Often you are given a tick the box survey to fill out. They dont know how the drugs work. The drugs are carefully formulated for max profit. People with valid medical conditions are pushed over to psychiatry because no pathology was found. They cash in on the vulnerable and tell them things like your pain in your back comes from being depressed. Ever asked a Dr what depression is? Each Dr has a somewhat different view of what depression is.

Its just one of the shady industries we have to put up with. Because there is so much money to be made there wont be a rush to review their practices in the near future.

Quokka Quokka 11:06 pm 13 Aug 10

Jethro said :

“Researchers at the Rand Corp. in 2002 surveyed close to 700 adults who had received a prescription for an antidepressant. Of those who reported receiving the medication for depression, just 20% tested positive when screened for the disease. Fewer than 30% of those receiving the medication had any depressive symptoms at all.” (http://www.psychologytoday.com/blog/side-effects/200905/overprescribing-antidepressants) (Yes, American study, I know… would not be the same here since our ban on advertising for prescription drugs)

Are you able to provide the link to the original Rand Corp article? I tried searching the website at http://www.rand.org but couldn’t find it. It may have been that the respondents returned the survey after they completed their treatment, in which case only 20% of the respondents having depression would actually be a good outcome!

I did actually find another article from Rand Corp on their website that stated that “only 20 to 30 percent of depressed patients seen in general medical practice were prescribed antidepressant medication. Among those who did receive a prescription, almost one-third were prescribed a subtherapeutic dose.” http://www.rand.org/pubs/research_briefs/RB4522/index1.

So rather than over-treatment, it seems there are many that end up missing out on effective treatment. Apparently the majority of patients with mental illness receive very little treatment whatsoever (62% according to the Mental Health Council of Australia – http://www.humanrights.gov.au/disability_rights/health/MHCA.doc)

Recommendations to the Australian Senate suggest that funding to Mental Health should be more than doubled and receive 14% of total health funding, rather than the 6% that is directed towards treatment of mental illness currently. (http://www.aph.gov.au/senate/committee/fapa_ctte/coag_health_reforms/report/footnotes.htm#c05f2).

Of course, medication is only a part of an effective treatment package and more money needs to be spent on all areas of treating mental illness. (e.g., psychological treatments, vocational support, supported accommodation, support for carers, etc)

JumpingTurkey JumpingTurkey 6:49 pm 13 Aug 10

@Jethro
You made some good points there.
I agree that there are many cases where perhaps a better approach to one’s stress / depressive symptoms or anxiety might have been simple reassurance, advice on lifestyle measures, and offering them to speak to a kind counseller or a psychologist.
Perhaps the use of anti-depressants mirrors the over-use of antibiotics for coughs and colds. I think the main reason for over use of antibiotics for coughs and colds are due to:
(1) The fact that it is lot easier for GPs to prescribe something rather than spending 5 minutes discussing differences between viral and bacterial illnesses and discussing symptomatic treatments. This might ring true for antidepressants where giving out medications and changing around medications and changing doses are far easier and convenient than not doing so and spending far longer time discussing non medication strategies.
(2) The fact that many people also find it easier to take something rather than doing the had yards. People want fast fixes. This is especially the case if you are paying a lot of money and waited a long time to see a doctor. They may not feel particularly good if all they are told is: “here go home and rest and take panadol, I cannot do anything for you”, or “here, you need to go and see this psychologist 12 times over the next 2 months, plus you need to cut back on your alcohol, smoking, caffeine, increase regular exercise, force yourself to meet people even if you don’t feel like it and get up in the morning”. They’d feel lot better and it will be far easier to pop a pill that a doctor has prescribed for you.
This is particularly the case if the actual condition doesn’t improve. Let me tell you, it does not feel good to see patients who return 3 days after being told that ‘its just a virus, take panadol, rest and fluids’ with worse symptoms, and there I have reach out for my script pad and prescribe antibiotics. While objectively speaking there is nothing wrong with the care that was provided and the treatment that was given, but you do feel some patients thinking in their heads ‘oh so now he gives me antibiotics, should’ve given this to me earlier’.
Similar thing may happen with psychiatrists. And stakes could be higher if someone then goes home without any medications and then kills himself / herself.

While I am not trying to say that these are valid reasons to continue oversubscribing I am just giving everyone here a picture of the complex picture of why some of these kinds of things may be happening. Hopefully you’ll come to the same realisation that these issues are not issues that can easily be addressed by extra ‘education’ or ‘training’ of psychiatrists or even of drug companies.

Jethro Jethro 6:08 pm 13 Aug 10

I think I’m being misunderstood. I’m not having a go a psychiatrists, other than saying I think there may be a tendency to over-prescribe drugs that can have serious side effects. My argument is more with the pharmaceutical industry, which is after all, a for-profit industry (hence wants as many customers as possible).

There is ample evidence that prescription medication is used for mental illnesses when there are other avenues that should be tried first.

“Researchers at the Rand Corp. in 2002 surveyed close to 700 adults who had received a prescription for an antidepressant. Of those who reported receiving the medication for depression, just 20% tested positive when screened for the disease. Fewer than 30% of those receiving the medication had any depressive symptoms at all.” (http://www.psychologytoday.com/blog/side-effects/200905/overprescribing-antidepressants) (Yes, American study, I know… would not be the same here since our ban on advertising for prescription drugs)

In terms of this type of medication being used in Australia… “it has been estimated that more than 50,000 Australian children are presently taking prescription drugs for “Attention Deficit Hyperactivity Disorder”. Between 1991 and 1998 prescriptions for dexamphetamine, the most popular stimulant used for ADHD in Australia, increased by 2400 percent.”

(http://www.theparentingcentre.com.au/index.php/celebrate/46-bobs-articles/66-australian-children-at-risk citing Law and Policy Journal of the National Children’s and Youth Law Centre (Australia). September 2002)

That is a significant increase that we shouldn’t just be accepting without question.

Ultimately, I am saying that as a society we may rely too much on the ‘cure-all’ allure of prescription drugs. The fact that so many contributors on here seem to just accept the alarmingly high level at which we medicate ourselves and, more significantly, our children is a little alarming. Medications like Ritalin for ADHD are not the same as antibiotics or contraception pills. They are designed to interfere with the functioning of the brain and are often based on little more than observation and comparison with ‘norms.’ The reliance on these types of drugs for juvenile or adolescent behavioural problems is something we should be concerned about.

JumpingTurkey JumpingTurkey 3:29 pm 13 Aug 10

Errr…
I’m pretty sure that Clinical Psychologists use all sorts of tools / surveys in their diagnosis and in treatment, but I doubt that many psychiatrists would use these… their diagnosis and management is based on a psychiatric interview.

Of course this doesn’t necessarily mean that this is bad – good, experienced psychiatrists can be very good.

JumpingTurkey JumpingTurkey 3:02 pm 13 Aug 10

I am going to state up front that I am a GP (as a disclaimer):

I have no desire to start a turf war beween GPs and psychiatrists. However can I clear up a misconception? Psychiatrists are NOT trained as GPs. GP training is a separate pathway altogether. In Australia you need to finish your hospital internship and residency (all doctors must do this), and then specialise. General Practice is one of the specialties – and it takes a minimum of 2 further years of training after finishing the residency.
Most psychiatrists would not have a clue on general practice and would not know how to treat any disorder except for that of the mind (just as a cardiologist would not know how to deal with any skin disorders).

It is true that GPs (let’s not kid ourselves, there are good GPs and bad GPs just like in any other fields) are able to treat most cases of mental health problems effectively using medications, counselling and in conjunction with psychologists.

Where psychiatrists come in handy are cases requiring hospital admission (as GPs have no admitting rights); psychotic people (where they may require non-voluntary treatments); and people who are really really in trouble (yes you get those patients where NO ONE has any clue on what’s going on, and in that situation the best strategy is to send them up to the person who has the most credibility / experience in these things – not only to ensure they get best care, but for legal reasons too).

And in terms of whether or not medications can cause side effects, yes they can.
Can they cause bad side effects, yes they can.
But can they save lives? Yes they can.

I have had many patients who were so depressed that they would simply not be here today (because they would have killed themselves) was it not for some of our medications.

And you tell me that we don’t need these medications.

motleychick motleychick 1:53 pm 13 Aug 10

There are also many other tests and guidelines that need to be completed and followed by a psychiatrist before they can prescribe medication. It’s not a matter of just going and getting a script filled out.

motleychick motleychick 1:51 pm 13 Aug 10

wickerman said :

Psychiatry is a load of rubbish and dangerous. Most shootings, suicides and other acts of violence can be linked to the latest multi million dollar pharmaceutical called SSSRIs. Psychiatry is a licence to print money and something should be done about them. Thats right our GPs can write out mind scripts if you think you need them, why the need to send ‘the more difficult cases to a shrink’? What a joke, they are not interested in you but your money. Because the drugs are loaded with dangerous side effects you will find you will go back to the Psychiatrist for a number of times to change your meds. Once you realise they are all too hard to take, you will choose one and take that until out of the blue you have suicidal urges like never before experienced. You see the formula is perfect for making lots of money. Scary isnt it. Psychiatry have NO diagnostic tests. When your Shrink says you have a chemical imbalance in the brain, ask for a test. Guess what….theres no tests for any psychiatry. Oh print some more money. I beleive these so called Drs are criminal and society pays them big for it. They know it and are laughing all the way to the bank.

Not sure if someone has replied to this – I couldn’t be bothered reading all the posts…

Psychiatrists and psychologists do use tests – they use the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) which contains all known mental disorders and the criteria to classify them. It is a worldwide manual.

And if you think that medications make people with a mental disorder worse, you are seriously mistaken. What a deluded view of such a serious issue. Mental illness is very debilitating for someone and although some medications have horrible side effects, it is better for someone who needs the stability to be on medication rather than be going through the stress and trauma of having to deal with their illness.

I find it saddening and disgusting that people like you still hold views like this about mental illness. Although I guess if you suffered from one of the more serious ones your views on the matter would be altogether different.

Skidbladnir Skidbladnir 5:54 pm 09 Aug 10

Jethro said :

Exposure to that sort of advertising for psychotropic drugs can only make you wonder about their necessity (why weren’t 15% of kids in the 50s on Ritalin or ADHD meds – and why did they get by OK?)

And all those kids born in 1950 grew up to be deathly afraid of communists, had a pretty good chance of being crippled with polio, unexpectedly dying from basic infections because the only things people could use was penicillin, and went on to have a severe risk of heart disease due to nobody caring about dietary fat.
The same doctors and nurses treating kids didn’t wear gloves when treating people or taking blood, because who ever heard of auto-immune diseases being transmitted by bodily fluids?

But there would probably be five times as many humans by now if it wasn’t for contraceptive pill.
And since 1955 the infant mortality rate has dropped by two thirds.
And we’ve invented the polio vaccine. And the measles vaccine. And the rubella vaccine. And the chicken pox vaccine. And the cervical cancer vaccine….
We advertise for things like flu vaccines before masses of people are dying, because its better to deal with things in small and preventable cases, instead of having massive numbers of people end up in the ICU with a slim chance of survival.

Same deal with other preventative mediciness.
Society accepts them as potentially needed because, dealing with chronic problems is hell.

Sure, with all of these drugs being invented and the social changes caused by them since the 1950s, there are so many choices of things to blame for society’s ills.
But yeah, lets attack the psychiatrists.

PS: To alleviate all forms of boredom, why not read an un-put-downable adventure of pathos, politics, war, humor, diplomacy and intergalactic finance…
All for $2.95 from any secondhand bookshop, it’s over 1000 pages of thrills, spills, vicious aliens, and noble humans.
It will help answer burning questions like:
Why are the evil Psychiatrists Catrists oppressing people through a sub-profession slave race called the Psychologists Psychlos, who in turn keep all of mankind ignorant of their own amazing mental powers?
Is mankind an endangered species, and how can fighting the Psychologists Psychlos and Psychiatrists Catrists by joining Scientology any church that rebels against them prevent further danger?
Will handsome and heroic Jonny Goodboy Tyler win Earth back from the nine-foot-high aliens, and show the other aliens the path to righteousness by abandoning their wartime economies in favour of blissful consumerism and giving money to a church?
Will humanity ever get rid of Jews the Selachee, a race of bankers who try to repossess the planet?
What is the point of Asians the Chinkos, a race of effeminate, intelligent, subservient aliens?

Yes, Battlefield Earth. Its fascinating stuff.

colourful sydney racing identity colourful sydney racing identity 4:08 pm 09 Aug 10

p1 said :

Jethro said :

(why weren’t 15% of kids in the 50s on Ritalin or ADHD meds – and why did they get by OK?)

Same argument crops up when defending any of the many “medical” systems opposed to some or all of “modern” or “western” medicine. We didn’t have antibiotics a hundred years ago and everyone got by fine. Except when they were dying from an ingrown toenail.

+1

p1 p1 2:52 pm 09 Aug 10

Jethro said :

(why weren’t 15% of kids in the 50s on Ritalin or ADHD meds – and why did they get by OK?)

Same argument crops up when defending any of the many “medical” systems opposed to some or all of “modern” or “western” medicine. We didn’t have antibiotics a hundred years ago and everyone got by fine. Except when they were dying from an ingrown toenail.

Pommy bastard Pommy bastard 1:42 pm 09 Aug 10

Jethro said :

It does seem that they invent drugs and then invent the disease to fit it.

Utter bunkum.

Jethro said :

(why weren’t 15% of kids in the 50s on Ritalin or ADHD meds – and why did they get by OK?)

Probably because Ritalin wasn’t licsensed for use in treating ADHD in children until teh 60’s? That may have something to do with it.

Bosworth Bosworth 12:55 pm 09 Aug 10

Sock-puppetry, wickerman and Jethro ?

or maybe they are the last two $cientologists in Canberra? Trying to grow the Org so that their superiors and AOSH ANZO will let them continue on the Bridge to Total Freedom(tm)

http://www.whatisscientology.org/html/Part02/Chp06/img/grdchart.gif

Jethro Jethro 9:32 pm 08 Aug 10

colourful sydney racing identity said :

Meyers: I did a little research and I discovered a startling thing…
There was violence in the past, long before psychiatry was invented.

Kent: I see. Fascinating.

Meyers: Yeah, and know something, Karl? The Crusades, for instance.
Tremendous violence, many people killed, the darned thing went
on for thirty years.

Kent: And this was before psychiatry was invented?

Meyers: That’s right, Kent.

With apologies to the Simpsons

While I wouldn’t go as far as wickerman in his condemnation of psychiatry, I feel (one Newbie looking out for another) that I’ve got to call Mr Racing Identity on this.

Meyers was a lobbyist for the violent cartoon (psychiatry) industry. Of course he would say that. Lobbyists for big pharma would say something similar, I’m sure.

There is most probably a place for psychiatry in our medical system. But I do have to agree with wickerman on the whole pharmaceutical industry thing. It does seem that they invent drugs and then invent the disease to fit it.

Anyone who has lived in or travelled through the States would be aware of the pharmaceutical advertising that goes on over there.Exposure to that sort of advertising for psychotropic drugs can only make you wonder about their necessity (why weren’t 15% of kids in the 50s on Ritalin or ADHD meds – and why did they get by OK?)

Likewise, anyone who has done any type of psych at uni would be aware that the whole thing relies heavily on statistics and norms, which is always a shaky type of thing on which to base the medication of a significant chunk of the population.

On a side note (if I may refer to a debate that has arisen every now and the on the-riotact): If Cannabis had the same mental side-effects as a lot of prescription psychotropic drugs there would not even be a debate about whether or not it should be legalised or regulated. It would be illegal. Forever. Fullstop.

Weed has side effects. For a small percentage of people they can be quite significant. But the percentage of cannabis users with negative mental side effects is significantly smaller than the percentage of users who get negative effects from some prescription anti-depressants and other psychotropic drugs. Of course, Cannabis isn’t supported by a multi-million dollar funded lobby group…

Quokka Quokka 9:24 pm 08 Aug 10

Common Tactics of Scientologists:

A) Trivialize critics.
B) Belittle, or start flame wars.
C) Re-Focus on triviality – make you focus on the twig so you do not see the woods.
D) Censor anything damaging rather than refute it. Or refute it with lies.
E) Put up a facade of confidence.
F) Use multiple accts to appear stronger.
G) Deny being a scientologist to falsely show neutral support.
H) Play the oppressed victim and demonize the critic.

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