Who's who in mental health services

If you or someone you support is accessing treatment for a mental health condition, you will probably come across a range of mental healthcare and welfare professionals who will have a role in the treatment.

If you are unsure about the role of the person treating you, ask them to explain it to you. In some roles within mental health services, formal qualifications vary and educational backgrounds differ. It is your right to ask any private healthcare professional about their qualifications and experience. Counsellors, for example, might have skills in talking therapies for anxiety or depression but no formal medical qualifications. Psychiatrists can prescribe medications, and some might also be trained in talking therapy or counselling. A local doctor, while practising as a general practitioner, might have a specialist interest and experience in the mental health area making them more 'qualified' to help than another local doctor who does not.

The following 'who's who' list will help you understand who does what in the mental health sector.

General practitioners

Your local doctor (general practitioner or GP) can help determine if you have a mental health condition. To do this, they will probably conduct a basic assessment of your mental health including a brief interview and physical examination, and they might order some laboratory tests. Your GP will ask about your mental health symptoms, your family history of mental illness and anything in your life that might be causing anxiety or stress.

General practitioners hold a medical degree and, to practise in Victoria, must be registered through the Australian Health Practitioner Regulation Agency (AHPRA), with the Medical Board of Australia. To practise as a vocationally registered GP they must also be a fellow of the Royal Australian College of General Practitioners. They may also be a member of the Australian Medical Association. GP services are either partly or fully claimable through Medicare, depending on the individual GP.

If you have a mental health treatment plan written by a GP, it usually qualifies you for subsidised mental health treatment through Medicare or the government's Access to Allied Psychological Services (ATAPS) program.

GPs can write mental health treatment plans and, depending on your needs, might refer you to a counsellor, psychologist, psychiatrist or other mental health professional.

Psychologists

Psychologists study human behaviour, investigating the processes related to how people think and feel. They conduct research and provide therapy and counselling to reduce distress and to help people manage psychological problems. They help people to deal with relationship problems, trauma, eating disorders, learning difficulties, substance abuse, parenting issues, loss or grief and managing the effects of a chronic illness. Psychologists cannot prescribe medication.

Psychologists who are registered to work in Australia have completed a minimum 4-year basic university program in psychology. Full registration as a professional psychologist requires a fifth and sixth year of graduate study in professional psychology.

Psychologists work in hospitals, community health services, schools, courts, prisons, the defence forces and private practice.

Psychologists practice different types of therapy, such as psychoanalysis, psychodynamic approaches, client centred approaches, cognitive behavioural therapy, and many more. You can ask your psychologist what types of therapy they are trained in, and discuss whether they are a good fit for your needs. For more information visit SANE.

You do not need a referral to see a psychologist. However, if you want to claim rebates through Medicare or to use the Access to Allied Psychological Services (ATAPS) program, you will need a mental health treatment plan, which your GP can develop. If you have private health insurance, you may be able to claim part of a psychologist’s fee, depending on your policy and level of cover.

Psychiatrists

Psychiatrists are medical doctors who have completed specialist training to help people with emotional and mental health problems. They diagnose and treat mental health issues. Psychiatrists can prescribe medication for mental health conditions, and some may also use talk-based therapies such as cognitive behavioural therapy.

To practise in Victoria, psychiatrists must be registered with AHPRA.

You need a referral from a GP to see a psychiatrist and to claim rebates through Medicare.

Authorised psychiatrists

Authorised psychiatrists are psychiatrists who have specific powers under the Mental Health Act 2014 to decide whether a person with a mental illness should have compulsory mental health assessment or treatment.

Compulsory mental health treatment can only occur when a person is subject to a Temporary Treatment Order or Treatment Order following assessment by a medical or mental health practitioner (Assessment Order) that a person they have examined meets the criteria for an Assessment Order. This order enables an authorised psychiatrist to examine the person without their consent, to determine whether the person requires immediate treatment to stop serious deterioration or to stop serious harm to that person or another person.

Mental health nurses

Mental health nurses are specially trained (some in psychological therapies) to care for people with mental health conditions. They work with psychiatrists and other healthcare professionals to treat people with mental health issues, providing information, support and care.

The duties of a mental health nurse may include:

• assessment of people's mental health status
• giving medication
• assisting in behaviour modification programs and other activities
• visiting and treating people requiring mental health treatment in their homes.

Mental health nurses work in mental health units, hospitals, nursing homes or out in the community. They are registered nurses (division 1), and most have undertaken further study in mental health, earning a graduate diploma or master’s degree.

Aboriginal and Torres Strait Islander mental health workers

Aboriginal and Torres Strait Islander mental health workers are health workers who understand the mental health issues of Aboriginal people, using it to provide culturally safe and accessible mental health services.

They are generally not medically trained but might have undertaken training in mental health and psychological therapies. Their role often includes:

• counselling
• case management
• screening, assessment and referrals
• health promotion and education
• helping Aboriginal people to access mainstream mental health services
• supporting the families of Aboriginal people with mental health problems.

You can find Aboriginal and Torres Strait Islander mental health workers in some mental health clinics, hospitals and Aboriginal health services.

Social workers

Mental health social workers work with people who are having a hard time because of a mental health issue. They support people with anxiety, for example, by helping them find ways to manage uncomfortable situations and understanding the causes of their anxiety, such as relationship issues, financial hardship and work stress.

Professional social workers hold a Bachelor of Social Work degree and you can find them in welfare agencies, hospitals, community health centres and other human services and justice organisations. Some social workers are also qualified as counsellors.

You can also see an eligible social worker through the Medicare-funded program Better Access, which requires you to start by getting a mental health treatment plan developed by your GP.

Counsellors

'Counsellor' is a general term for various professionals who offer some type of 'talking therapy'. A counsellor may primarily work as, for example, a nurse, social worker, occupational therapist or psychologist. Some have a specific counselling qualification such as a Bachelor or Master of Counselling degree.

Counsellors help people work through personal problems. They help people to recognise and define their emotional, health, mental and lifestyle problems and to understand themselves and their behaviour better. They help people by:

• explaining options
• setting goals
• providing therapy
• supporting them to take action.

Not all counsellors have specific training in treating mental health conditions and services offered by counsellors usually do not have a Medicare rebate available. Make sure you check that the counsellor has a qualification or has been recommended by your GP or other people experiencing the same issues as you. It is a good idea to check that the counsellor you choose to see is registered with an appropriate professional body.

Peer workers

Peer workers are trained mental health professionals who have their own personal experience of mental health problems and recovery. They have studied how to use personal experience in ways that are therapeutic. Peer workers do not base their work on diagnoses or standard treatments of mental illness, but instead on respect, shared responsibility and mutual agreement of what is helpful.

Peer workers can share their own experiences so that you know you are not alone, and you can explore different ways to make sense of your experiences. Research suggests that peer work can increase hope, independence and a sense of empowerment.

Peer workers are a relatively new type of mental health professional but are increasingly employed by many different types of mental health services.

Mental health occupational therapists

Occupational therapists work with people to help them to be better able to participate in everyday life, by helping people to enhance their own abilities, and by modifying the external environment. Occupational therapists who specialise in mental health have particular skills in understanding some of the ways that mental health problems might create barriers to participating in life, work and the home. They may be able to assist in developing coping strategies, building confidence and independence.

Professional occupational therapists hold a Bachelor of Occupational Therapy degree and they are required to be registered with AHPRA.

Occupational therapists work in welfare agencies, hospitals, community health centres and other human services and justice organisations. You can also see an eligible occupational therapist through the Medicare-funded program Better Access, which requires you to start by getting a mental health treatment plan developed by your GP.

Some occupational therapists have additional qualifications as counsellors.

Mental health recovery and rehabilitation workers

Mental health recovery and rehabilitation workers specialise in working with people who have developed a psychosocial disability as a result of a mental health condition. They may be qualified as social workers, psychologists, peer workers, occupational therapists, or have a Certificate IV in Mental Health (non-clinical).

Mental health recovery and rehabilitation workers offer support and rehabilitation services that aim to support people towards personal recovery. This means working with people to understand the impacts of mental health problems on their life, and developing goals that are meaningful to them.

Common areas of personal recovery include building social connectedness, finding hope, addressing the identity impacts of mental health problems, making sense of mental health experiences, finding meaning in life, and building a sense of empowerment. Mental health recovery and rehabilitation workers will often work with people to join or rejoin employment, and to find safe and secure housing.

Mental health recovery and rehabilitation workers work in sub-acute mental health services, and in mental health community support services.

Where to get help

• Your GP (doctor)
• Psychologist
• Psychiatrist
• Social worker
• Counsellor
• Occupational therapist
• Mental healthcare professionals