Please help - Free/subsidised (more than Better Health) for DBT/ACT?

[akemi]

Hi,

I'm in desperate need of help. My boyfriend is very close to crisis point, and has been suffering with mental illness for most of his adult life (he just turned 30). His experience with therapy (since teenhood) has nearly always been negative - every psychologist he's been referred to has always employed CBT which simply does not work for him (he's quite alexithymic/cannot comprehend his own thoughts and feelings and finds classic CBT incredibly frustrating), and the cost of therapy has been extremely prohibitive for him (even with a Better Health Mental Health Plan) because he is a low-income earner (less than 50k before tax) and has no support from his family. I cannot support him on my income either. He feels completely trapped, he lives paycheck to paycheck and spending money on therapy that has thus far been unhelpful means he is dissatisfied, unmotivated and disenchanted. I've managed to convince him that perhaps a different type of therapy may be more beneficial (DBT, ACT, Interpersonal) but finding a therapist that specialises in these has been hard, and the ultimate hurdle will always be cost.

Can someone provide ANY suggestion or advice on what we can do? I feel like he has slipped through the cracks of our government's various mental health options. He doesn't fit the category of "Young Person", his income isn't low enough to get a health care card, he doesn't have any other special concessions.

He knows that he needs help, he wants help, but he just can't afford it and we don't know what to do. Today he told me he's thinking about different ways to kill himself because he feels so lost.

Please help me.

[Croix]

Dear Akemi~

I'm sorry, you are faced wiht such a very worrying situation and no easy solution. As I'm sure you would have thought already your boyfriend talking of suicide is a warning signal that something needs to be done promptly.

Firstly looking at measures you might want to consider for the short term:

If you ever feel your boyfriend is in danger contact emergency services straight away. It is better to ensure he keeps living, even if it seems a big step, or you worry how he will feel about your actions afterwards.

He should be equipped with a Safety Plan which sets out what to do, who to call, activities and lots of other things if he gets overwhelmed or frighted he might take his life. You can help him a great deal here. The beyondblue free smartphone app BeyondNow is excellent for this, and your knowledge of him will help immensely getting it filled in in advance if you do it together.

https://www.beyondblue.org.au/get-support/beyondnow-suicide-safety-planning

When entering emergency numbers I'd particularly recommend The Suicide Call Back Service (1300 659 467) who are capable, understanding and professional - a real comfort

I think a Mental Health plan is limited to psychologists and covers a set amount for up to 10 sessions in a calendar year, with the gap still payable. Not really a satisfactory setup. If your BF had been seeing psychologists and this has not helped I guess the only other obvious step is for him to see a psychiatrist.

This will probably not be cheap, though the annual safety net can help a lot. The advantage is a psychiatrist does not have the limitations a psychologist does. Finding one that firstly charges a reasonable amount and secondly has the right experience to deal wiht your boyfriend's condition may not be straightforward. I'd suggest enlisting his GP to help find one.

You do need to look after your own welfare. This situation is a highly stressful one, and probably will continue one way or another for quite while. I'd suggest medical support in the shape of advice from your GP and most importantly personal support from someone who can share your load. Do you have parents, family or friends you can talk to who will care and understand? My partner had her mum which made a huge difference.

As a final suggestion try to get your BF to lead as least stressful and most distracting and enjoyable lifestyle he can. Even little things help.

Please keep on talking, you can gain perspective and others' experiences here

Croix

[Bethie]

Hi

I just did a bit of research. Some psychiatrist bulk bill. If you do a search in your area I'm sure you'll find one.

But like Croix said have a plan ready if worse case happens with your bf. Only other thing i can add is keep a spare phone charger in your bag. If he needs to go to hospital in a emergency you could be there for a very long time and might need to reach out to family and freinds

[akemi]

Thank you for your reply Croix,

I will have a look at the app and will talk to him about whether using a phone service or other online help might be something he'd like to look into. It's hard right now because his mood is so volatile that if I say the wrong thing he spirals and it's so hard to bring him back up again.

Unfortunately I think a psychiatrist is out of our means right now. I think he would really benefit from starting a course of antidepressants, but again, his mood is so volatile I worry that suggesting it may put him into a deep hole. I'm not sure how to broach this with him without it turning into a huge issue and upsetting him.

I know that trying to figure out how we can get him into therapy has been a major source of anxiety and that if we could just sort this out it would help a lot with making him feel calmer and more optimistic. I just feel so stuck because I can't afford to cover the gap, unless it was say, $20 or $30 - I don't know where to begin with finding a psychologist who does anything other than CBT and charges within this rage.

I think we need to find him a good GP - he's only been going to the medical centre near his house because it bulk bills, but the doctors there have been quite unhelpful in the past. So that's another thing we need to look into.

I feel very bogged down. He is completely overwhelmed by anything to do with his mental health right now and has been leaning heavily on me for help, but it's really affecting my mood too. He lashes out or withdraws and I don't know how to help him when he's treating me like this.

I'm at my wits end. I just want to find him help that won't send us broke.

[Croix]

Dear Akemi~

Thanks for coming back and talking more. You really need support too you know. Having the burden of your BF's illness on you is really too much for one person to keep doing alone. Have you been able to enlist anyone else - perhaps in his family or yours - to help? If he is inconsistent and lashes out at times the strain and uncertainty needs to be shared if at all possible.

The on-line service I mentioned is good but for emergencies, not for on-going treatment. And that is the problem you face. I think you are correct in finding a good GP first. Simply accepting the duty doctor in a medical center pool is probably not going to be enough. Once you have a GP on your side then the search for proper help can start. As Bethie says there are some psychiatrists who bulk-bill, and others whose gap is not too large. A bit of a hunt to find one unfortunately.

Please let us know how you get on

Croix