Mental Health Care around the world

Gosh

It all seems so complicated, surely the last thing you need when you are ill is to worry about insurance coverage. I guess I am very lucky where I live.

Paddy

i didn't realize this was the case in canada. i think i've heard others here mention that in the uk only cbt is available. is that right? we've had a lot of conversations in the psychotherapy forum how so many of us just don't respond to cbt at all.

im in Australia i think our healthcare system isnt too bad. I have a thing called a health care card because i am on centrelink (think its called welfare in other countries?) and i get a parenting payment but its not much as my boyfriend has a job. But with my health care card i dont pay to see a docor, pdoc or my T. i also get my meds very cheap, pay $9.45 for my prozac and will pay $5.30 for my ADHD meds...so i think its not too bad here...

[QUOTE=Shangrala;1143158]It has been brought to my attention that my comment of concentrations camps in the US was offensive.
I should note as well, that I used the wrong term for said camps. It should be noted that they are "Inernment camps"..NOT consentration...Hope that clarifies for some.
(And anyone who knows me also knows that is SO not my style...TO offend).
To those who it has offended, please know that by NO means was I implying anything in relation to past history.

It was my lame way of expressing my disgust in our own country...that it is my personal opinion that it wouldn't surprise me that our own government isn't arranging these 600 or so "camps" nationwide to imprision us american citizens..when they so decide to. That's all.
(Google: "FEMA concentration camps, USA" if you care to know what I am referring to..and I really am not the paranoid type..just trying to see it as it is).

My apologies to all I may have offended.

Shangrala
[/QU hey shangrala, you are ok by me. You poor thing! You must have gotten a ton of pm's on this! I know your posts and i was not offended bv as i read it, i knew what would be comming your way...bet you got a lot of angry feedback! If anyone referred to the holocaust, yeah i can understand. The mentally ill were murdered because the nazi's were brainwashed to believe the mentally ill were deemed to be "life unworthy of life". Now i am going to read that fema article! Take care and see you on the boards! Carol

In Australia, we have a full public health system......for everything....

The pro......you don't have to pay for anything and most drs and nurses are excellent.

The cons(here we go).......we do not have enough hospitals to accomodate everyone, waiting lists for elective surgery are enormous and up to 4 years, we do not have enough beds and our ED are overcrowded with not enough staff including mental health triage, management in senior positions are incompetent, hence, the domino effect, our medicare system allowed GPs to bill for services so for the people that cannot afford $80 for a doctors visit......end up in EDs.

I worked in the public health system for 5 years and it was full on......great team of people but we were all stressed out with the workload of pathology in a major hospital. Massive issues.....

Also our private health care is enormously expensive, and our federal award wages do not reflect the expense. So if you are not earning $100000 up per annum, it is hard to afford.

Yep, Aus has a long way to go to meet international standards of operation.....improve the system get more professionals......we have a shortness of doctors. The ones we have though, are excellent.....

Thanks Paddy,

Michah

Here I am paying $45.00 per week for DBT--it is coded a certain way so Medicaid & Disability or whatever pays for it its. I am self-pay.

an example of waiting time in Australia
went to doctor about ears they have been playing up for 2 yrs
finally told the doc I want to see a specialist so she sent the referral
warning me there would be a wait well yes I expected a wait no problem
letter arrives "due to the fact that you do not have cancer your waiting time will be approx 10 yrs" wtf

In Australia. Here insurance is a choice but if you don't have it you are charged an extra tax. The govt subsidise anyone up to 30% of the premium.

Insurers are sneaky here and they put together impossible packages which are definitely not psych patient friendly. You can only have a psychiatric cover in a public hospital not a private one unless you pay nearly $80 a month more than anyone else. plus you have to pay an excess (starting at the first $200) unless again you have a very high premium.

They don't question or reject treatments which is a really good thing. If they did that here there'd be a revolt and everyone would opt out of it.

They do send a letter asking your doctor if your situation was evident before you joined the insurance, because they refuse to pay for anything that was in evidence before you joined.

90% of the psychiatric services here are government run and are very good programs depending on which state you live in. The NSW system sux because the psych teams there are only concerned with how easy they can get off. Like the less work but getting paid seems to be their go.

In the State I live in the services are really good. They follow a program which assesses people and from that assessment you are assigned for assistance. The GP is the one who is supposed to decide on medication unless he has referred you to a psychiatrist or a neurologist, then they oversee what ever you're on.

Overall I think we have one of the best systems in the world because we have choices. The only thing that is a problem are the charges and the crazy packages. It would be better if they allowed people to choose from a list of items they want to be covered for instead of giving them 35 items of cover they will NEVER use.

Because health is State not Federal (Yet) each State is different in their waiting times for public/medicare patients NSW is probably the worst I've ever seen. But others may disagree

Where I live in Victoria Australia - access to Mental Health Services are dreadful. There is ONE Public Ward in a Public hospital that has 30 beds which is meant to cover half the entire state. It will only accept you if you highly psychotic. If you might be a danger to yourself they dont cater for that. This is for people with and without Medical Health Insurance. I know of people who have been rejected from this unit and they are no longer with us.

If you have Medical Health Insurance and are not a danger to yourself or any-one else you may find a bed in the only Private Mental Hospital, which also caters for those with an eating disorder. There are 30 beds. You may or may not be lucky enough to get a bed at the time of your illness due to a lack of beds. Some P'docs seems to use this hospital as a revolving door for their patients. At the private hospital, if they have a bed available, you can have your own P'doc.

If you choose to pay for health cover then you can choose your own P'doc (but the good ones have closed their books due to the fact they are over worked). You will pay a gap fee of $555:00 and then the Govt will pay 80% percent of all medical expenses incurred outside a hospital. If you choose to see a psychologist and have Medical Insurance there is very little recompense from the Medical Insurer.

Due to Medicare most medications, if you are receiving government subsidies, (ie pensions or newstart allowance) cost $5:70. However if you are prescribed a medication not deemed to be linked with your illness you will pay the full price. For example I use the medication Seroquel. Because I do not have schizophrenia or bi-polar (and using lithium or sodium valproate) then I must pay $200 per month.

It seems amazing that we have a major lack of doctors and nursing staff right across the board.

Recently my mother was ill and in the emergency room with a suspected twisted bowel. Eight hours later we were told that there was a bed. We arrived on the ward to hear the charge nurse say 'take her back down we don't have any beds available'. Eventually there was a three way 'discussion' between the charge nurse the ER nurse and the bed co-ordinator. The nurses were lovely but run off their feet.

Our hospital has a nice new look on the outside..... but the rot is on the inside.

Yes, psychiatric hospital care is certainly difficult to come by in Australia unless you have private health insurance or are independently wealthy. Luckily I have a psychiatrist who bulk bills me (meaning I pay no gap at all) but yes, his books are closed too. It is particularly difficult that those who are most in need of inpatient care are least able to afford it, since public hospitals, as mentioned before, will generally only cater for people in crisis.

warmest wishes to all

Roaz

despite the problems with insurance, i do believe australians have one of the better systems of health care in the world. i would love it if we adopted a universal health care approach as seen in some european countries, but i doubt that would ever happen.

i am absolutely blessed to have found a psychiatrist who bulk bills me, so i dont ever have to pay an out of pocket fee. he also does not mind bending the rules to prescribe my PBS-subsidied medications that are not linked to my diagnosis.

i think our experiences of the health care system are probably highly dependent on the doctor you get, and how much effort they want to/are able to put in to help you out. i needed to go in for surgery last year and was told the waitlist was over 6 months long. but my specialist pulled some strings and got me seen within 10 days.

i dont have private health insurance myself, but if you shop around there are some ok deals out there. i found one at the beginning of the year where i only had to pay $6/week, and it included private psychiatric hospital cover. psychiatry is the only real reason i would get private health insurance - our public system is abysmal on that front. my dr has preferred to see me every 2nd day & phone in between sessions rather than admit me to a public ward.

Because we have up to four levels of government here in the states, it is very confusing. Some programs are funded locally, some are funded by the state and some are funded nationally. And, then, some are funded only privately, so that's five different sources of funding. And it is up to the individual program design as to what levels they accept payment from.

I participated in a program after my inpatient stay in May that was housed in the hospital where I was inpatient. But, the program was outpatient daily, six days a week. You didn't have to go all six days, it depended upon what the psychiatrist recommended. But, if you were disabled and received Medicare, it was covered. Seems odd to me because I have private insurance and, therefore, the way our Medicare system works, supposedly private insurance pays first and Medicare picks up the part private insurance doesn't pay. But they assured me that Medicare would pay for it. And I'll be darned if they didn't pay for it!!! I was shocked. I just got my notice of payment last week and it was covered 100%! My decuctible ($1,080) for Medicare was taken care of through the inpatient stay and therefore, Medicare kicked in. I was truly amazed. I was there for 5 weeks and it was a very good program. I am thinking of asking if I can go back as I'm having some difficulty with depression again and I'm not sure if they think it's appropriate but I'm going to ask anyway.