Hi, I have mental health issues and I would like to know what makes a good or bad psychiatrist, psychologist or neuropsychologist.
Each type of mental health worker will have a different area of speciality, as well as different qualifications, training and experience.
In your question, you talked about psychologists and different areas of specialisation like clinical psychologists, neuropsychologists and psychiatrists, all of whom play a role in the assessment and treatment of mental health conditions.
Understanding the role of each and how it aligns with your needs may help you in your decision.
Psychologists in general
Psychologists provide assessment and therapy to clients, either through individual or group format and aim to enhance a person’s well-being.
A psychologist typically completes a minimum of six years of training, including university and practical experience, and is required to be registered with the Psychology Board of Australia.
Clinical psychologists provide a range of psychological services to people across their life. Services typically focus on the assessment, diagnosis and treatment of mental illness.
Clinical psychologists complete additional supervision in the practice of clinical psychology beyond their six years of university.
Clinical neuropsychologists assess and treat people with brain disorders that affect memory, learning, attention, reading, problem-solving and decision-making.
Like clinical psychologists, neuropsychologists complete those six years and receive additional supervision in the practice of clinical neuropsychology.
Psychiatrists are doctors who are experts in mental health. They diagnose and treat people with mental illness and prescribe medications, if appropriate.
Psychiatrists typically complete four to six years of an undergraduate medical degree before undergoing general medicine training within a hospital. Then they complete several years of specialist training in psychiatry and must be registered with the Australian Health Practitioner Regulation Agency.
You might need to try a few therapists to find the right one
Therapy requires a person to feel safe and secure and establish trust with another person. So the fit between the two of you matters.
In the same way you may try a few hairdressers or GPs before you feel in safe hands, you may need to try out a few therapists before you find the right one.
Try not to feel disheartened; your persistence in this area will pay off.
Ideally, you should select a therapist who is appropriately qualified but also, one you can connect and engage with. To test this, you should leave the first session with a sense of hope, even in the face of challenges.
This is not to say therapy will always be a comfortable process. It will be your therapist’s job to encourage and support you in making uncomfortable changes, so there may be times where you feel challenged or uncomfortable. It’s helpful to communicate this openly with your therapist and allow space to explore this with their support.
Ask your community for recommendations
Word of mouth can be an excellent tool when sourcing a good therapist. Consider asking your GP, family, friends or local community who they recommend.
Once you have some names, do your homework. Look up their qualifications, read about them if you can, and make sure that they practise in the area that you need.
Mental health is a broad term and as such, therapists may choose to focus on particular areas within it. If the therapist you’ve chosen doesn’t practise in your area, don’t worry – just ask them if they have a referral suggestion for you.
Find out how much they charge
In Australia, there are a lot of different ways to access mental health support. Some options include private practitioners working in clinics or schools, community services and public mental health services. Each of these settings will have a different fee or access structure associated.
For example under Medicare, a person may be eligible for up to ten sessions (individual and/or group) with a registered psychologist per calendar year with a referral from their GP.
These sessions may be bulk billed (with no out-of-pocket expense), or there may be a fee associated and rebates available. Fees can vary greatly, however the Australian Psychological Society recommends a fee of A$251 per 50-60 minute session. Medicare rebates range from A$86 (for psychologists) to A$126.50 (for clinical psychologists and neuropsychologists). This would leave you out of pocket A$124.50 or A$165.
Out-of-pocket costs for private psychiatrists also vary. They may be bulk billed, or charge a fee. An initial consultation may cost around A$400, with a Medicare rebate of A$201.35, leaving you out of pocket A$178.65.
Mental health services at headspace are either free or low cost. And some schools also offer free psychological services.
Ask your GP about the specific costs and rebates when you discuss referral options.
Consider going online
While there is much to be gained from the personal experience of therapy, access can be a problem in some regional and remote area of Australia.
Thankfully, there are a number of excellent online resources available:
Centre for Clinical Interventions provides online resources and self-directed therapy modules for bipolar, anxiety, depression, eating disorders and other mental health conditions
Beyond Blue provides support for anxiety, depression and suicide prevention
Black Dog Institute is dedicated to understanding, preventing and treating mental illness. It has a range of resources, particularly for depression and anxiety
Brave supports young people to overcome anxiety.
Remember, we all struggle from time to time. For many, therapy plays an important role in improving their mental health and setting them back on their path.