Exploring the pros and cons of Mental Health Care Plans
So, you've probably heard about GP Mental Health Care Plans (MHCPs; sometimes also referred to as MHTPs for ‘Treatment’) as a way to access mental health services more affordably.
They're often the go-to from GPs when you're considering mental health treatment and the type of support/practitioner they refer them on to. However, like anything, they come with their own set of pros and cons.
Many of us are not familiar with some of the implications of the MHCP - and to be clear this article is not designed to deter you from them in any way as they are invaluable for many. But it is important for all of us as health/mental health consumers to all the information to enable us to make the best decisions for our particular circumstances and needs. So let’s take a look.
The Upsides of Mental Health Care Plans (MHCPs):
Accessible Sessions: With an MHCP, you can typically access up to 10 sessions over a calendar year.
Reduced Costs: If your chosen psychologist or social worker bulk bills, the sessions can be free. However, this is quite rare. In most cases, you will incur a gap fee. The recommended fee by the Australian Psychological Society is $300 for up to one hour, whereas the Medicare rebate under an MHCP currently stands at $92.90 for a registered psychologist, or $136.35 for a clinical psychologist. Therefore, your out-of-pocket cost could exceed $200 per session.
The Downsides of Mental Health Care Plans (MHCPs):
Limited Sessions: The number of available sessions is restricted. This could be a concern if you're working through issues that may quickly exhaust your allocated sessions. Equally, if you’re accessing sessions via your Employee Assistance Program (EAP) it’s usually 3-5 sessions per year and often these practitioners are counsellors.
Mental Health Disorder - Diagnosis Requirement: To obtain an MHCP, you need a mental health disorder diagnosis, which becomes a part of your medical records. This has raised concerns among some people who worry about potential stigma, insurance implications, or assumptions made by service providers.
(Note: I was refused life insurance because of this and had been completely unaware of it before).
Therapeutic Constraints: MHCPs limit the types of therapies you can receive - often Cognitive Behaviour Therapy (CBT) or Dialectical Behaviour Therapy (DBT) might be used - narrowing your treatment options. Given most psychologists work largely from a medical model that might be something that’s helpful to you, or it might not be.
A holistic perspective (biopsychosocial) recognises that mental health includes physical health, social support, lifestyle factors, self-care practices and nervous system regulation. Effective treatment - certainly for grey area drinking, ADHD or anxiety - should include the person’s multiple dimensions and offer a range of options to support them in this.
Again, it is what works for the client.
Lack of Choice: You can't self-refer with MHCPs. Your GP will likely refer you to their network of psychologists or social workers, giving you limited control over your choice of therapist.
Confidentiality Concerns: After therapy is completed under an MHCP, your psychologist or social worker is required to report back to your GP. This means that complete confidentiality might not be guaranteed.
Legal Implications: If you're involved in legal proceedings, your MHCP sessions may appear on a Notice of Charge document, potentially exposing your treatment details to others which can then be subpoenaed (e.g. forcibly admitted to court).
Long Waiting Times: Psychologists and social workers who accept MHCPs can be in high demand, resulting in long waiting lists for treatment currently. It’s not uncommon for books to be closed to new clients or 6-12 month waiting periods, at the time of writing.
The Alternatives? Psychotherapy, Counselling or Coaching
The Psychotherapy and Counselling Federation of Australia, and the Australian Counselling Association, are currently working on a 2 year project with the Federal Government to develop National Standards to bring counselling in line with other allied health professions which may result in MHCP eligibility. This is likely a number of years away.
However, many counsellors don’t wish to work under the Medicare system for the types of reasons listed above.
Their focus is predominantly on the ongoing therapeutic relationship with the client and their healing and wellness, rather than viewing the client through the lens of a ‘mental disorder’. (Both definitely have a place).
There is also the freedom to practice with a variety of different modalities (which are evidence-based, but not eligible under the MHCP). If you're seeking an alternative, a well qualified counsellor or coach might suit you. However, make sure you check their credentials as these professions are not well regulated.
Here are some key advantages to a counsellor/coach:
Self-Referral: You can refer yourself, giving you more control over the process.
Freedom of Choice: You can choose your own practitioner and the type of treatment that suits you best. There are no restrictions.
Privacy: No diagnosis is necessary, ensuring your treatment doesn't affect other areas of your life or go on your medical records.
No Labels: You don’t have to have a disorder, identify in a particular way (e.g. “an alcoholic”) or have mental health issues. Human struggle is part of life for everyone. We take a strengths-based approach.
Chances are you a human who is being challenged by something you need some support with - and that’s "‘normal’!
Flexible Sessions: You can have as many sessions as you need.
While psychiatrists, psychologists, mental health social workers, counsellors, psychotherapists and coaches ALL each offer valuable support, it's essential to choose the path that aligns best with your needs and preferences.
Having said that, it’s important that we ‘stay in our own lane’ in our own therapeutic specialities and refer our clients on appropriately when they need more support than we are able or qualified to provide.
A coach or counsellor might need to refer to a psychiatrist or clinical psychologist if a client is experiencing significant mental health issues or anything requiring specialist treatment e.g. substance withdrawal, eating disorders, paranoid delusions.
Bottom line, your mental wellbeing as a client must be the highest priority for any practitioner that you see, and from a duty of care and ethical perspective they will want you to get the right support for you.
I hope this has been helpful. You’re most welcome to reach out faye@fayelawrence.com.au if you have any questions!
Sources:
[1] https://www.healthdirect.gov.au/mental-health-treatment-plan
[3] https://psychology.org.au/for-the-public/about-psychology/what-it-costs
[4] http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=80000&qt=item&criteria=psychologist%20Mental%20Health%20Care%20Plan
[5] https://www.health.gov.au/initiatives-and-programs/better-access-initiative?utm_source=health.gov.au&utm_medium=callout-auto-custom&utm_campaign=digital_transformation
[6] http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=80100&qt=item&criteria=psychologist%20Mental%20Health%20Care%20Plan
[7] http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=2712
