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Guest Vapourware

The healthcare system - Australian style

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Guest Vapourware

I thought I would write about how the Australian mental health system is like, from my experience. This is my experience based on the private system, as I have private health insurance.

Pre-Admission

Before entering the hospital, it is a good idea to check your insurance cover to see how much it will cover. Reception at the private hospital usually has a good idea if you tell them of your type of insurance cover, and they can offer an estimate of how much the stay will cost. If you have just recently [within the last two or so months] joined up with insurance cover, then it is a good idea to check with the insurance company that your waiting period is over, and that you can claim for the stay. Most insurance companies will require you to wait two months before being able to claim for psychiatric hospital care.

Generally, it is a good idea to have the highest private health insurance cover possible, to off-set the cost of private hospitalisation. My private hospital would have cost $689/night outright, but I only had to pay $25/night out of pocket for a single room, up to a maximum of ten nights.

There are two options you can take with your health insurance. You can choose a cheaper monthly payment but you may have to pay a certain excess [extra charge upon entering the hospital]. Or you can pay a higher monthly payment but not pay any excess. It depends on how many times you think you will need the hospital. The excess is usually $200 which is a once-off payment per calendar year.

It's also good to check what items you can bring to the hospital. Some private hospitals can be very generous with what you can bring inside. So you may be able to bring items like your phone and laptop, in addition to the usual books and the like.

Admission

Admission is fairly straight-forward. The reception will ask you to sign some forms, and they will also show you a preliminary list of charges which is basically what they would have told you over the phone. Then they will show you to your room.

A nurse will do the intake, and it will involve going through a checklist regarding your level of depression and self harm, plus any drug or alcohol use. The questions are asked to help the hospital see where you are coming from, and what they are working with, and usually they will give you a copy of the results when available. They will also ask you to do a urine test and will probably take your blood pressure and temperature as well.

Treatment

The mainstay of treatment at a private hospital are their therapy groups. The majority of the groups are based around depression, and the group therapy is CBT-based. There are groups that rotate through the the week, so you can join in when you wish.

There are also other groups - such as relaxation groups and art therapy groups. The relaxation groups are focused on meditation, while the art therapy groups have a variety of mediums where you can express yourself creatively. There's clay, paint, crafts and spots where you can sketch.

If you want to step out of the hospital for a few hours, you must inform the nurses. Sometimes a doctor will allow you leave from the hospital, while sometimes a doctor may require you to stay within the hospital grounds - either your doctor or nurse will clarify this from you. The nurse may ask you for contact details, where you are going and when you will be back. They can be pretty strict with this because technically you are under their care and therefore their responsibility - so if you don't come back within the alloted time, be prepared for a barrage of phone calls.

Medication is served per night, and the nurses will come around to each patient individually to serve the tablets. They will also do regular welfare checks during the course of the night. It's fairly unobtrusive - they will open the door and flash a torch around to make sure you are in your bed.

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Sometimes I wish I were back in Australia, if only for the fact that private medical insurance is much more affordable, and the law states that the insurance must cover you for existing mental health issues after a minimum wait period from signing up (I think it's about 2 months?). I'm in New Zealand now and it is very different, there are very few private mental health facilities around, and health insurance is much more expensive, plus most will not cover you for pre-existing mental health issues, unless you wait 3 years, and even then it's not guaranteed that they will cover you. However if you're on a low income, you can get access to community mental health services which are kinda crappy usually, but are mostly free. I have no idea what the public mental health hospitals are like here, and hopefully will not ever have to find out.

When I was in Perth, a friend of mine attempted suicide and was first admitted to a public mental hospital as he was no cooperative with treatment...to be honest, it reminded me a lot of "one flew over the cuckoo's nest", and the first chance I got after that, I signed up for private health insurance to make sure I would never end up there. The private mental health clinic that my friend transferred to later, was really nicely set up. Nice rooms, friendly staff...I did a 2 week CBT course run at one of them (paid for by my insurance) and was impressed by what was available. I had another friend stay at a different private mental health clinic and she said that one was similar, a very nice, clean, professional set up.

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edit:

That sounds great but plz remember when it comes down to it if ur involuntary u have to be in a public hospital.

Edited by waypills666

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That's the main difference between the public and private system.

Public

The public system is risk-focused. If you are scheduled under the mental health act then you will always go to a public hospital. The focus is to stabilise you on medication and discharge you as soon as possible, preferably within a few days. Because of the acute nature the other patients tend to be more distressed and from what I've heard, it feels more chaotic. It's a good option if you are an immediate risk to yourself or others. If you would like to know more about your rights in a public hospital see here.

Private hospitals are sub-acute. If you need a nurse to be with you all the time then you will be scheduled and moved to the closest public hospital.

Private

Admission:

At my hospital reception did a formal 'health fund check' where they called my fund for me to ensure I was covered. I had the highest level of cover and had waited two months so I didn't pay any excess.

My admission process was similar to vape's except mine actually searched my bags for any medications or sharps. I was allowed my phone and laptop.

Treatment:

Nurses help patients into a routine, so they will wake you up in the morning and ask that you be dressed before going into common areas for meals. In my hospital medications were dispensed from the Nurse's station, not brought to us. Some people took medications at breakfast, lunch, evening, night and nightime sedation medication not just at one particular time of night. It sometimes got annoying having to line up for medications.

At my hospital, groups were very interactive. I've heard that others in my area are more lecture-style. They are somewhat CBT based but concepts from other therapies like acceptance and commitment therapy and mindfulness were included.

The hospital I went to also ran day groups, and towards the end of the stay patients were allowed to attend appropriate day groups instead of in-patient groups to encourage them to continue after discharge. Stays in private hospitals are longer than in public, a minimum of 10 days and usually a max of six weeks. I think around 2-3 weeks is the norm.

If you would like to know more about your rights in a private hospital, please see here.

Edited by bluelikejazz

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Just a quick question. from what has been written here I would be better off getting priv health insurance when I can afford it to treat my mental health.

My current public system medico's are all fantastic and care I have my gp and my psych's mobile and they both said call or text anytime I feel the need to

for example my gp's reception said i couldn't see her for another week I called her last night and I'm seeing her this morning.

I think its just a matter of finding the right medico's. 

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Maybe the wrong forum to ask but i thought it might be silly making a thread but does anyone know in Australia (Victoria) If the ER/ Hospital - public keep records on you? Dating back over 5 years?

I'm wanting to know for upcoming pdoc apt. My mental health record's are apparently lost somehow over the years and moving area's something has gone wrong.

The mental health records are from when i was a teen - and over 5 years ago when went into ER/(OD'd)

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Each state has their own specific laws re: medical records. Generally you'll be able to access them as public hospitals will have your records somewhere, although you may have to pay a fee for transferal. Talk to the OAIC or your state's privacy ombudsman for more information.

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45 minutes ago, Savannah said:

May I ask how much private money nsurance cost? I am in the US and want to  compare the two.

Depends on various factors like which state you live in, your age, your gender, your income, what level of coverage, your gap, what type of coverage (just hospital or hospital and extras, what type of extras if so etc) and the insurance company itself. 

Typically you need a high level of hospital at least to start reducing psych restrictions. 

Edited by Hopelessly Broken

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