Mental illness can be treated. When someone first starts to develop symptoms of mental illness, it is important to contact a doctor or a community mental health service for help.
The correct treatment can help a person’s condition to improve or help a person to live well, despite the presence of some ongoing symptoms. Psychological treatments are often the most helpful for people affected by anxiety disorders or depression, while medications are mainly helpful for people more severely affected by mental illness.
Sometimes, the symptoms can be so confusing for the person that they do not realise they are ill. In this case, family or friends can visit the doctor to seek support and advice about how they can best help the person.
Initial assessment of mental illness
A doctor will make a diagnosis based on the person’s particular pattern of symptoms. For example, symptoms that may indicate the person has depression include:
- feeling ‘down’ for a prolonged period
- not sleeping
- being unable to concentrate.
The doctor will then talk to the person about the best treatment for the symptoms and their underlying causes. Sometimes, the diagnosis changes as symptoms change or as other information about the person and their illness becomes known. The most important thing is for the doctor to understand the symptoms so that the most helpful treatment can be selected.
The doctor will talk to the person about how the treatment will work and explain any side effects. The person can ask the doctor questions about the proposed treatment.
Psychiatrists and general practitioners
People affected by mental illness may benefit from a range of treatments. Medical treatment (or referral to other health services) can be provided by:
- A local doctor (general practitioner or GP) – can make an assessment and prepare a Mental Health Plan to help the person get treatment and support. This may include referral for psychological therapy from an appropriately qualified health professional, which may be largely covered by Medicare. A doctor can also provide ongoing treatment for many people. Some doctors undertake further training to specialise in this area. Doctors also play an important role in making sure that the physical health of a person with a mental illness is not neglected.
- A psychiatrist – is a medical doctor who specialises in the study and treatment of mental illness. Most people affected by mental illness will have contact with a psychiatrist at some stage of their illness. Those more seriously affected will have more regular contact.
Help for people with mental illness
As well as seeing a doctor, you can access services in both the private and the public health sectors, including:
- Public healthcare – this includes treatment in public hospitals and community mental health services. The advantages of this system are that it provides a range of services in the community and there is no direct charge.
- Private healthcare – it is possible to see a psychiatrist or psychologist who works in private practice. This usually involves paying a fee and then claiming a Medicare rebate, if the person is eligible. It is also possible to be an inpatient at a private clinic or hospital. However, unless the person has private health insurance, this will be expensive.
Community mental health services
Treatment may be provided either in the community or at an inpatient service. Mental health services are increasingly provided in the community by:
- A case manager –will support the person’s recovery and help them to access all the services they need (for example, housing and employment support). They will also help educate the person – and their family or carers – about the illness and how to manage it.
- Acute community intervention teams – groups of mental health professionals who provide assessment and support for people who are seriously affected by mental illness. They can visit the person in their home and arrange for admission to hospital if needed.
- Community support teams – provide longer-term support to the person in their home. Support teams try to reduce the number of admissions to hospital a person may need, and can help them to maintain a treatment plan and improve their quality of life.
Psychological treatments for people with mental illness
Psychological treatments are based on the idea that some problems relating to mental illness occur because of the way people react to, think about and perceive things. They are particularly relevant to many people with anxiety disorders and depression.
Psychological treatments can reduce the distress associated with symptoms and can even help reduce the symptoms themselves. These therapies may take several weeks or months to show benefits.
Different psychological therapies used in the treatment of mental illness include:
- Cognitive behaviour therapy (CBT) – examines how a person’s thoughts, feelings and behaviour can get stuck in unhelpful patterns. The person and therapist work together to develop new ways of thinking and acting. Therapy usually includes tasks to perform outside the therapy sessions. CBT may be useful in the treatment of depression, anxiety disorders and psychotic disorders such as bipolar disorder and schizophrenia.
- Interpersonal psychotherapy – examines how a person’s relationships and interactions with others affect their own thoughts and behaviours. Difficult relationships may cause stress for a person with a mental illness and improving these relationships may improve a person’s quality of life. This therapy may be useful in the treatment of depression.
- Dialectical behaviour therapy – is a treatment for people with borderline personality disorder (BPD). A key problem for people with BPD is handling emotions. This therapy helps people to better manage their emotions and responses.
Treatment with medication for people with mental illness
Medications are mainly helpful for people who are more seriously affected by mental illness. Different types of medication treat different types of mental illness, including:
- Antidepressant medications – about 60 to 70 per cent of people with depression respond to initial antidepressant treatment. These medications are now also used (in combination with psychological therapies) to treat phobias, panic disorder, obsessive-compulsive disorder and eating disorders.
- Antipsychotic medications – are used to treat psychotic illnesses, for example, schizophrenia and bipolar disorder. Newer antipsychotic medications may have some side effects, but tend to have fewer of the effects that were associated with the older medications, such as stiffening and weakening of the muscles and muscle spasms.
- Mood-stabilising medications – are helpful for people who have bipolar disorder (previously known as manic depression). These medications, such as lithium carbonate, can help reduce the recurrence of major depression and can help reduce the manic or ‘high’ episodes.
Other forms of treatment for mental illness
Effective treatment involves more than medications. Treatment may also include:
- community support – including information, accommodation, help with finding suitable work, training and education, psychosocial rehabilitation and mutual support groups. Understanding and acceptance by the community is very important
- electroconvulsive treatment (ECT) – this treatment can be highly effective for severe depression and, sometimes, for other diagnoses when other treatments have not been effective. After the person is given a general anaesthetic and muscle relaxant, an electrical current is passed through their brain.
- hospitalisation – only occurs when a person is acutely ill and needs intensive treatment for a short time. It is considered better for a person’s mental health to treat them in the community, in familiar surroundings.
- involuntary treatment – can occur when the psychiatrist recommends someone needs treatment, but the person doesn’t agree. People only receive compulsory treatment to prevent serious deterioration in their mental or physical health, or to prevent serious harm to the person or another person.
Where to get help
- SANE Australia Helpline Tel.1800 18 SANE (7263)
- Your doctor – for information and referral
- Community mental health service
- beyondblue Support Service Tel. 1300 22 4636
Things to remember
- A doctor or a community health service is the first place to visit when a person becomes unwell with mental illness.
- Sometimes, the symptoms can be so confusing for the person that they do not realise they are ill.
- Psychological treatments are often the most helpful for people affected by anxiety disorders or depression.
- Medications are mainly helpful for people more severely affected by mental illness.
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