Mental illness can be treated. When someone first starts to develop symptoms of mental illness, it is important to contact a general practitioner (GP) 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 can be helpful for people affected by a mental illness. However, sometimes medications are needed, especially if symptoms are impacting significantly on the person’s life.
Sometimes, the symptoms can be so confusing for the person experiencing them that they do not realise they are unwell. 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 mental health professional makes a diagnosis 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.
The mental health professional will then discuss with the person what the best treatment options are for the symptoms and possible underlying causes. Sometimes, the diagnosis changes as symptoms change or as other information about the person and the illness becomes known. The most important thing is for the mental health professional to understand the symptoms so that the most helpful treatment 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.
Psychiatrists and general practitioners
People living with mental illness may benefit from a range of treatments. Medical treatment can be provided by a general practitioner (GP) 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 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 may have more regular contact.
Help for people living with mental illness
In Victoria, public, private and specialist mental health services for people living with mental illness include:
- public mental health services – these are accessed through GPs. People seriously affected by their illness can be referred to the specialist mental health service system. 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 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 are only hospitalised when 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 also educate the person and their family or carers about the illness, and how to manage it
- 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.
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) to show benefits.
There are many different psychological therapies used in the treatment of mental illness. 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. CBT may be useful in the treatment of depression, anxiety disorders and psychotic disorders such as bipolar disorder and schizophrenia
- 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 illness and improving these relationships may improve their quality of life. This therapy may be useful in the treatment of depression
- 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. A key difficulty for people living with BPD is managing emotions. This therapy helps people better manage their emotions and responses.
Medications for 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 – these medications may be prescribed (in combination with psychological therapies) to treat depression, anxiety, phobias and some eating disorders
- antipsychotic medications – are mostly used to treat psychotic illnesses, for example, schizophrenia and bipolar disorder. These medications may also be prescribed for major depression or severe 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
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