Harmony SeekerMany people, including myself, have struggled with accessing good mental health care in Australia, so I thought I would break down how the system works. I will also discuss why it often falls short, especially for those of us who need ongoing support.
Let’s start with Mental Health Care Plans (MHCPs). On paper, they seem like a solid option. Your GP gives you a referral, and suddenly you’re entitled to up to ten psychology sessions per year with a Medicare rebate. That’s meant to mean lower costs, but most psychologists charge around $200 per session, and even with a rebate, you’re still left with a significant out-of-pocket expense each visit. Ten sessions in a year? That’s less than one session a month, which is nowhere near enough if you’re dealing with anything chronic or complex. If you need more support, you’re on your own. For lots of people, it isn’t financially possible. So, even with these plans, ongoing mental health care isn’t affordable. The only real option is crisis support or hotlines like Blue Knot; these are important, but no substitute for regular, meaningful help.
And then there’s the kind of care that’s on offer. In my experience, therapists tend to default to Cognitive Behavioural Therapy. I get why as it's evidence-based and well-structured. However, for me, it just hasn’t worked. I’ve found much more value in modalities like Internal Family Systems where there’s more room to explore, rather than “fix.” But finding a therapist who’s open to these approaches, let alone really skilled in them, is rare and they’re almost never bulk-billed. The type of care you can actually access is heavily dictated by what’s mainstream and what’s financially feasible, not by what might help you.
What’s frustrating is how often therapists seem locked into one way of working. There’s a lack of flexibility, a lack of listening. Sometimes, it’s like they’ve got a script. For example, I once saw a counsellor who suggested I “do more enjoyable activities,” as if that was some kind of revelation. When you’re already doing what you can, that kind of advice just feels dismissive. It highlights the gap between the world of mental health care and the realities of people’s lives, especially for those who don’t fit the mould. I'm worn out by therapy itself, the effort of advocating for myself, by the exhaustion of being misunderstood, and by the sense that the system isn’t built for people like me. It’s not that therapy is without value, but the way it’s delivered; both the limited access and the limited range of approaches can make it feel ineffective. And with my own late diagnosis of autism, I’ve become even more aware of how much the mental health system simply doesn’t see, let alone accommodate, neurodivergent adults.
So, what needs to change? I’d start with more sessions per year, and a lower out-of-pocket cost. No one should have to choose between therapy and paying the rent. We need bulk-billing and means-tested support for people who can’t work, or can only work part-time. The rebate system should cover a wider range of therapies, so people can actually choose what works for them, not just what’s cheapest or easiest to access. And therapists need to be willing to work flexibly, to be curious, and to move away from the idea that there’s one right way to “heal.” We need less cookie-cutter, more real-world, person-centred care.
The medical model still dominates mental health; the idea that everything is an individual pathology is part of the problem. It’s time for a shift toward a social and inclusive model, where the focus is on removing barriers, reducing discrimination, and building a system that recognises people as whole, complex individuals. That’s what I’d like to see, and what I believe a lot of us in the community would benefit from.
If you’ve navigated the system, I’d love to hear your experiences—what’s worked, what hasn’t, and what you wish was different. I’m always keen for suggestions for future content, and I’m especially interested in what other neurodivergent or marginalised communities think about all this.
#MentalHealth #ActuallyAutistic #Neurodiversity #Ifs #Cbt #MentalHealthCarePlan #Medicare #Counselling #Burnout #SocialModel #Accessibility #AustralianPsychotherapy #Melbourne
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