What should I do if I can’t see a psychiatrist?

People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.

But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.

If you can’t get in to see a psychiatrist and you need help, there are some other options. However in an emergency, you should call 000.

Why do people see a psychiatrist?

Psychiatrists are doctors who specialise in mental health and can prescribe medication.

People seek or require psychiatry support for many reasons. These may include:

• severe depression, including suicidal thoughts or behaviours
• severe anxiety, panic attacks or phobias
• post-traumatic stress disorder (PTSD)
• eating disorders, such as anorexia or bulimia
• attention deficit hyperactivity disorder (ADHD).

Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available a range of team members can contribute to a person’s mental health care.

Can my GP help?

Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.

GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behaviour.

The GP Psychiatry Support Line also provides doctors advice on care, prescription medication and how support can work.

It’s a good idea to book a long consult and consider taking a trusted person. Be explicit about how you’ve been feeling and what previous supports or medication you’ve accessed.

What about psychologists, counsellors or community services?

Your GP should also be aware of supports available locally and online.

For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment and access to treatment.

Medicare Mental Health Centres provide in-person care and are expanding across Australia.

There are also virtual care services in some areas. This includes advice on individualised assessment including whether to go to hospital.

Some community groups are led by peers rather than clinicians, such as Alternatives to Suicide.

How about if I’m rural or regional?

Accessing support in rural or regional areas is particularly tough.

Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.

Should I go to emergency?

As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.

But going to a hospital emergency department will be essential for some who are experiencing a physical or mental heath crisis.

Managing suicide-related distress

With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.

Roughly nine Australians die by suicide each day. One in six have had thoughts of suicide at some point in their lives.

Suicidal thoughts can pass. There are evidence-based strategies people can immediately turn to when distressed and in need of ongoing care.

Safety planning is a popular suicide prevention strategy to help you stay safe.

What is a safety plan?

This is a personalised, step-by-step plan to remain safe during the onset or worsening of suicidal urges.

You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.

Safety plans usually include:

1. recognising personal warning signs of a crisis (for example, feeling like a burden)
2. identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
3. seeking social supports for distraction (for example, visiting your local library)
4. letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
5. knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
6. making the environment safer by removing or limiting access to lethal means
7. identifying specific and personalised reasons for living.

Our research shows safety planning is linked to reduced suicidal thoughts and behaviour, as well as feelings of depression and hopelessness, among adults.

Evidence from people with lived experience shows safety planning helps people to understand their warning signs and practice coping strategies.

Are there helplines I can call?

There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):

Suicide helplines:

There is also specialised support:

Additionally, each state and territory will have its own list of mental health resources.

With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.