Do pdocs always?

I see my Pdoc through a Government run clinic, and he does therapy with me (anywhere from 20-50 minutes depending on what I need at each session). He also encourages complementary treatments such as meditation, yoga, and fish oil. Haven't started on the fish oil, because of the cost, but I'm definitely seeing benefits from the meditation and yoga.

I feel like I've made more progress with him in the past few years than I've made with any other Pdoc or T in the last 20 plus. Yes he also prescibes/recommends medication in my case, which I make the choice to take, but if that's all he did (ie throw pills at me) I wouldn't still be seeing him.

We have a crisis team that visit in 4- 6 pack , they are totally useless and I call the team in crisis, not crisis team .

omega fish oil is not expensive , you can buy it any super drug store or the like. Its a bit more from health shops .

Not super expensive, no, but on top of everything else it's an extra cost we can't really afford. And by everything else I mean food, bills, mortgage payments, my husband's migraine medication, my pain medication, my psych meds, higher education fees, debts from a failed business we're still paying off, and so on. We're not exactly what you'd call living in a higher socio-economic bracket, so unfortunately things like fish oil capsules end up being a luxury.

It used to be common for pdocs to do therapy. First dsm 3 came along which promoted medicine as a tool. You see they were seeing the demise of their careers because of psychotherapy and therapy which are much cheaper. They needed a way to differentiate themselves. Then insurance came along which reduced payment and encouraged them to shorten times to 30 minutes so they can get paid for more patients.

Today I actually think we could make this model work if there was a more patient centered model where the entire team works together with the patient. This is different from most current practices because it means the team meets together and with the patient and ideally with the family. Not regularly but at some interval. It is being practiced in some countries.

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We have community health centres (CHC) that provide counselling which is done by social workers and therapists. A lot of them do home visits. A consulting psychiatrist is also available.

Assertive community treatment team (ACTT) psychiatrists visit their clients in their homes or other places, such as cafes.

A home visit is a lot more relaxed than a rigid and formal hospital one. There is no sterile environment with clerks and charts that separate the client from the doctor. People tend to be more cooperative and relaxed in their natural environment. This allows the client and the psychiatrist or therapist to develop a closer relationship.

I see my psychiatrist at a CHC. I prefer this over the hospital outpatient clinic that I used to attend. It is much more relaxed and there is no need for me to address her as Dr. We use first names. I have met with the social worker at my place and at a coffeeshop. It is so much nicer than sitting in an office.

I don't know about decking. The psychiatrist would probably just leave and call the police.

So no insurance like the Americans , and no NHS like us Brits. How do your hospitals and health care run if you don't mind me asking

We have a two tiered system - Public (Universal healthcare, ie Medicare) and Private. Anyone can use the public system, but it's your choice whether you also take our private cover as well. If you do take out private cover you get some tax breaks in regards to the public system (you don't have to pay the annual tax levy for medicare, for example). I use the public system - which for Psychiatrists who bill through medicare (public system) usually means a general payment of around $50 a session. Because I see my Pdoc through a Government run clinic though and not as a private provider who simply bills through medicare, I don't have to pay anything.

In terms of medication we have the PBS (Pharmaceutical Benefits Scheme), which makes medication more affordable, but it still ads up. Monthly, for myself alone I'm looking at.

Zyprexa - $36.90
Tramadol (for neuropathy) -$30.10
MS Contin (for endometriosis) - $18.50
Valium - $13.40
Ventolin - $8.50

Total $107.40

Like I said you add that onto mortgage payments, food, bills, credit card debts from a previously failed business (damn global financial crisis/recession), higher education fees + involved costs for husband's uni degree (working to get a better career in order to improve our own standard of living), and things soon start to get pretty tight money wise. Of course we try to keep a small amount aside for recreation, and the odd treat every now and then - still keeping within our budget. Some might argue I could use that to buy fish oil capsules, but I find having that allowance for recreation/treats is also beneficial to me mental health wise, perhaps more so.

There's more info on our healthcare system here:

Health care in Australia - Wikipedia, the free encyclopedia

Just to add to the above, our mental health system tends to work in one of a few ways.

Your first port of call is generally your GP or Primary Care Physician (PCP). They are the ones that generally do the initial assessment and decide where to refer a patient on to. Patients can also outright request a referral to a particular sort of mental health provider as well. To see a Psychiatrist you have to be referred by a GP. Depending on the severity of your presenting issue they have several options they can utilise. I'm not going to talk about presentations of simple stress or mild reactive depression, because otherwise we'll be here for a month of Sundays.

Say for example if you're problem is deemed to be moderate to severe depression. A GP can start you on medication and refer you to 10 sessions of CBT based counselling conducted by a Psychologist, which is subsidised by the Government. Or they could refer you to a Psychiatrist for further assessment, the Psychiatrist would then work up a treatment plan, and the GP and the Pdoc would work together to implement that plan, with the GP perhaps taking care of the medication side of things (under the Pdoc's instruction) and the Pdoc taking care of more therapy related stuff.

If, like me, you present with something a little more severe (Psychotic Depression for example). Then your GP would refer you for assessment by the Acute Crisis Intervention Service. A social worker and mental health nurse pays a visit to your home for an initial assessment, then you are referred onto a Psych resident at a Government clinic for further assessment. If you are in an acute crisis situation then steps will be taken to get you stable again as quickly as possible - that could be anything from meds, to hospital, to social support, to intensive outpatient therapy. If you're deemed not to be in acute crisis, but still suffering a mental illness that required more long term treatment/therapy, then you would be referred onto a private Psychiatrist.

In my case I was assessed by the Acute Crisis Intervention Service, but was found to not be in an emergency or acute crisis situation, even though it was considered I had a severe mental illness that required longer term care than they could provide. At this point I should have been transferred out to the care of a private Psychiatrist who billed through the medicare system, but the Govt. clinics lead physician happened to see the notes on my case and took a special interest and I received a phone call saying he'd like to take me on as a long term patient. He sees me as a private patient, but he puts me through as a clinic patient, so the fees are waived.

To clarify... Medicare isn't universal healthcare. It fills a gap. We don't have universal healthcare. We have better access to insurance including subsidies that also fill a gap. I still have to pay a lot for insurance.

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I'm in Australia, here Medicare is Universal healthcare.

Gotcha! I've heard fairly positive experiences with Australian health care.

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if you a top earner , national insurance that we pay out our wage packet every week can be high , could be £200 a week if big earner, average working class guy about £40 so that's £160 a month regardless of any treatment that's how the NHS works, at the end of your working life you may have easy payed in£100,000 and never been ill once. if working still pay for your meds at a fixed rate. BBBBBBBBBut if you never work through illness or your an immigrant , or on benefits you still have the same care has the paying punter , its designed to help the chronic sick, but get abused by med tourist quite a few actually fly from America and get free heart surgery costing thousands of $ in America and nothing hear, the eastern European come to England sign straight up to a GP for free health care we have payed all our lives into . that's where the system has failed and now on its knees , you could land in England from Poland and be having brain surgery for free a week later,

I don't know why they call themselves "The Crisis Team" as you say they are useless