Fighting for mental health reform

The Geelong Advertiser ran a feature on the increasing difficulty in accessing adequate mental health services. After more than 15 years with the same psychologist and psychiatrist and increasingly feeling that neither were able to provide what I needed I sought other options.

Enquiries into psychiatrist availability often identified they were not taking new clients, and if they were, fees were approximately $350 for the first visit of which you received about $220 back from Medicare. A pensioner or low income earner cannot afford those fees.

I was informed Primary Mental Health Partners offered a Medicare funded service with an approximate 3 month wait. I obtained an appointment within 4 months. The 1st session was with a registrar who took a history over one and a half hours. A 2nd session of less than an hour included the registrar and a psychiatrist. During this appointment I was advised of the Dissociative Identity Disorder, Complex PTSD and Somatic Symptom Disorder diagnoses. The 5 page report that followed would, if I was emotionally fragile – was Mary – have been enough to consider suicide.

Apart from the shock of the Dissociative Identity Disorder diagnosis, after years of being told that was not possible, the most significant message I strove to convey, my lack of memory, had been dismissed once more.

It was decided I ‘needed to work on a fundamental emotion which is rage. My identity Mary has the active form of rage whereas Liz has a passive form which results in the latter somatising it as physical pain and the former internalising as emotional pain.’ This passive rage was the result of being the sibling of a child with chronic illness who required constant attention and I needed to ‘unpack’ that rejection. After explaining I had little or no memory of the 1st thirty years of my life – how could I ‘unpack’ emotions or experiences I had no memory of.

Devastated, I attempted to make a further appointment to clarify, but this was not possible – only a review in 3 months would be possible – and no follow appointments would be available after that. It was suggested I see a private psychologist – that nothing was available in the public system.

Those three months seemed the longest of my life. When finally I had the opportunity to express my disappointment and frustration, how overwhelmed I was, it was met with surprise. Apparently, people were happy with this service. It was explained that to meet Medicare funding criteria, psychiatrists are expected to make such assessments, however damning or shocking or overwhelming or incorrect, within a 50 minute 1st appointment. The registrar was expected to do that to pass his exams.

Not only is it impossible to access appropriate services, Medicare funding that requires psychiatrists to make such horrendous decisions; decisions that can determine life or death choices for fragile people, is severely flawed.

Finding Mary is a condemnation of how inadequate the mental health system was over 40 years. However, I feel we all believe and expect it should be better in 2015. I once wrote of hoping that one day my story may be used to influence the training of mental health professionals. The only way that will happen is to put voice and face to my story, to highlight the failures.

When I find the courage to begin telling my story publically, I will focus on the devastating destruction of my life created by abuse, how painful it is living without memory, but – most importantly – the failure of the mental health system and the fight that is required for reform.