What If I Can’t See a Psychiatrist?

When You Can’t Get in to See a Psychiatrist, What Are Your Options?

People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.

But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.

Why do people see a psychiatrist?

Psychiatrists are doctors who specialise in mental health and can prescribe medication. People seek or require psychiatry support for many reasons, including:

• severe depression, including suicidal thoughts or behaviors
• severe anxiety, panic attacks or phobias
• post-traumatic stress disorder (PTSD)
• eating disorders, such as anorexia or bulimia
• attention deficit hyperactivity disorder (ADHD)

Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available, a range of team members can contribute to a person’s mental health care.

Can my GP help?

Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.

GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behavior. The GP Psychiatry Support Line also provides doctors with advice on care, prescription medication, and how support can work.

What about psychologists, counsellors or community services?

Your GP should also be aware of supports available locally and online. For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment, and access to treatment.

How about if I’m rural or regional?

Accessing support in rural or regional areas is particularly tough.

Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.

Should I go to emergency?

As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.

But going to a hospital emergency department will be essential for some who are experiencing a physical or mental health crisis.

Managing suicide-related distress

With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.

What is a safety plan?

This is a personalized, step-by-step plan to remain safe during the onset or worsening of suicidal urges.

You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.

Safety plans usually include:

1. recognizing personal warning signs of a crisis (for example, feeling like a burden)
2. identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
3. seeking social supports for distraction (for example, visiting your local library)
4. letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
5. knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
6. making the environment safer by removing or limiting access to lethal means
7. identifying specific and personalized reasons for living.

Our research shows safety planning is linked to reduced suicidal thoughts and behavior, as well as feelings of depression and hopelessness, among adults.

Are there helplines I can call?

There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):

Suicide helplines:

Suicide Helpline: 1800 123 456

Lifeline: 13 11 14

Beyond Blue: 1300 224 467

Mental Health Line: 1800 614 811

There is also specialized support:

Eating Disorders Helpline: 1800 123 456

Post-Traumatic Stress Disorder (PTSD) Helpline: 1800 013 0022

Additionally, each state and territory will have its own list of mental health resources.

With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.