Mental illness treatments

There are many treatment and support options to help people experiencing mental health conditions. When someone first starts to develop symptoms of a mental condition, it is important to contact a general practitioner (doctor) for help.

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 can be helpful for people affected by a mental health condition. Sometimes medications are needed, especially if symptoms are impacting significantly on the person’s life. There are also other options that can help support recovery.

Family and friends can also seek advice around treatment and support options to support their loved ones. This might be necessary if the person experiencing symptoms is unsure about seeking help, or does not realise they are unwell.

Initial assessment of mental health conditions

A mental health professional can make an assessment based on a person’s particular pattern of symptoms. For example, symptoms that may indicate a person is experiencing depression include feeling ‘down’ for a prolonged period, not sleeping or sleeping too much, or being unable to concentrate. This might involve face-to-face consultations, questionnaires, behavioural assessments, and sometimes consulting with others including friends, family, teachers, or other health professionals.

The mental health professional will then come to an understanding about what the person is experiencing, and they might make a diagnosis. They will then discuss with the person what the best treatment options are for the symptoms and possible underlying causes. Sometimes, a diagnosis changes as symptoms change or as other information about the person and their symptoms becomes known. The most important thing is for the mental health professional to understand the symptoms so that the most helpful treatment and support options can be selected.

The mental health professional will discuss with the person how the treatment will work and explain any possible side effects. The person can ask the mental health professional questions about the proposed treatment. They might also recommend accessing other health professionals, community supports, or resources as an adjunct to treatment.

Types of Mental Health Professionals

Medical treatment can be provided by a GP (doctor) or a psychiatrist.

A GP will often conduct an initial assessment themselves, discussing the outcome and treatment options with the person. They may then refer the person to a specialised mental health professional, such as a psychiatrist, psychologist or mental health social worker for treatment and support. Medicare rebated treatments are available. GPs also play an important role in making sure that the physical health of a person living with a mental health condition is not neglected.

A psychiatrist is a medical doctor who specialises in the study and treatment of mental health conditions. Many people affected by mental illness will have contact with a psychiatrist at some stage. Those who access medication for their mental health may have more regular contact.

Other mental health professionals.

Types of help for people living with mental health conditions

A GP or psychiatrist referral is usually required to access mental health services.

In Victoria, public, private and specialist mental health services for people living with mental health conditions include:

• public mental health services – the public mental health system includes hospitals, community-based services, early intervention programs, and residential services. Some services are for children and adolescents, whereas others are for adults. Generally, there is no fee to access public mental health services.
• specialist mental health services –the impact or severity of a person’s illness, rather than a specific diagnosis, is generally the trigger to access specialist mental health services. Specialist mental health services in Victoria are based on catchments. They are divided into two service delivery types:
  • clinical services – focus on assessment and treatment of people living with a mental illness. These services are called area mental health services and are managed by general health facilities, such as hospitals
  • non-clinical services – are called Mental Health Community Support Services (MHCSS). These focus on activities and programs that help people manage their own recovery and maximise their participation in community life
• private healthcare – this includes health professionals who work in private practice. Private healthcare usually involves paying a fee. Medicare rebates may or may not be available. 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.

People may need to have an inpatient stay in a hospital if they are acutely unwell and can be best supported with intensive treatment for a short time. Treatment at home and in the community is preferred.

Community mental health services

Where symptoms significantly impact upon a person’s ability to live day-to-day, more intensive professional supports may be provided either in the community or in an inpatient service. (An inpatient service is where someone is admitted to the hospital by a doctor for some sort of treatment or service, even if they do not stay overnight.)

Mental health services are increasingly provided in the community by:

• case managers – may be provided to help support a person’s recovery and help them to access services they may need (for example, housing and employment support). They may also educate the person and their family or carers about the mental health condition, and how to provide support
• crisis teams – provide community-based assessment and treatment for people experiencing a psychiatric crisis. Community-based assessment and treatment (CAT) services aim to prevent unnecessary hospitalisation, by providing treatment in the person’s own environment such as in their home. CAT services provide urgent assessment and will arrange inpatient admission if this is the most suitable treatment option
• community support programs – provide longer-term support to people in their home and community. Community programs try to reduce the number of admissions to hospital, and assist people to gain better mental health and improve their quality of life. Supports provided by community programs may include: support coordination, specialised assessments, counselling, coaching and learning, group recreation and leisure activities, supported independent living residential services and family and carer support.

Psychological treatments for mental illness

Psychological treatments (or ‘therapies’) help by giving people an opportunity to talk about their thoughts and feelings with a specially-trained professional in order to understand and cope with their symptoms. They can be accessed in the community or in hospital settings.

Psychological treatments can reduce the distress associated with symptoms and can even help reduce the symptoms themselves. Depending on the person, these therapies may take time (often months), but they can have long-term benefits.

There are many different psychological therapies used in the treatment of mental health conditions. Each person needs to find the therapy that works for them. Not all treatments are helpful for everyone.

Some examples of psychological therapies include:

• cognitive behaviour therapy (CBT) – examines how a person’s thoughts, feelings and behaviour can get stuck in unhelpful patterns. The person and a therapist work together to develop new ways of thinking and acting. CBT usually includes tasks to perform outside the therapy sessions.
• interpersonal psychotherapy (IPT) – examines how a person’s relationships and interactions with others can affect their own thoughts, behaviours and feelings. Difficult relationships may cause stress for a person with a mental health condition, and improving these relationships may improve their quality of life.
• dialectical behaviour therapy (DBT) – is a therapy generally used for people living with borderline personality disorder (BPD), but can be helpful for other psychological issues. This therapy helps people better manage strong emotions, cope with distress, and improve relationships.

Medications for mental health conditions

Medications are mainly helpful for people who experience certain types of mental health conditions, or who might be experiencing more challenging or severe symptoms. Often, medications are prescribed alongside psychological therapies or other types of support.

Different types of medication treat different types of mental health conditions, including:

• antidepressant medications – these medications may be prescribed (in combination with psychological therapies) to treat symptoms of mental health conditions including depression and anxiety, phobias and some eating disorders
• antipsychotic medications – are mostly used to treat symptoms of psychosis, for example, symptoms of schizophrenia and bipolar disorder. These medications may also be prescribed for people who experience more severe symptoms of depression or anxiety
• mood-stabilising medications – are helpful for people living with bipolar disorder (previously known as manic depression). These medications can help reduce the recurrence of major depression and can help reduce the manic or ‘high’ episodes.

Where to get help

• Your GP (doctor)
• SANE Help Centre Tel. 1800 18 7263 Monday to Friday, 10 am – 10 pm
• SANE peer support moderated forums
• Beyond Blue Support Service Tel. 1300 22 4636