Do You Need a Referral from a GP to See a Psychologist in New South Wales?

Navigating the world of mental health services can seem complex, particularly when it comes to understanding the steps involved in seeking professional help. One question that commonly arises is whether a referral is necessary to see a psychologist, particularly for those located in New South Wales (NSW), Australia. This article aims to clarify this process and provide insights into accessing psychological services in NSW.

You don't need a referral...

The simple answer to the question is: No, you do not need a referral to see a psychologist in NSW. Psychologists are primary health care providers, which means you can make an appointment directly without a referral from a doctor or psychiatrist.

However, there are certain circumstances where a referral becomes important, particularly when it comes to the cost of psychological services and the ability to claim a rebate.

But, getting a referral can be beneficial...

While not necessary to access a psychologist, a referral from a General Practitioner (GP) can be beneficial. This referral usually comes in the form of a Mental Health Care Plan (MHCP), a strategy developed by your GP for managing a mental health issue.

The MHCP outlines what services you will receive, what treatments are recommended, and defines your goals for treatment. Having a MHCP not only ensures a coordinated approach to your care but also allows you to access a Medicare rebate for up to 10 psychology sessions per calendar year.

How a GP Can Help in Your Mental Health Journey

A GP is often the first point of contact when you experience mental health concerns. They can provide an initial assessment, diagnose mental health conditions, provide ongoing care, and refer you to specialized mental health services, such as psychologists.

For example, if you're experiencing symptoms of depression, your GP can assess these symptoms, consider potential physical health issues that could be contributing to your feelings, and provide initial treatment recommendations. They can also develop a MHCP, which outlines a structured approach to managing your mental health, and refer you to a psychologist or other mental health professional for specialized care.

In the context of the MHCP, your GP remains involved in your care, monitoring your progress, adjusting the plan as necessary, and providing additional health care services. This comprehensive and coordinated approach can enhance the effectiveness of your mental health treatment.

Comparing Scenarios: With and Without a GP Referral

Let's consider two scenarios to better illustrate the difference between seeing a psychologist with a GP referral and Mental Health Care Plan (MHCP) and without one.

In the first scenario, Jane is feeling persistently low and has been struggling with feelings of hopelessness. She decides to see a psychologist directly without consulting her GP. She finds a psychologist through an online directory, books an appointment, and starts her therapy sessions. Jane pays for the full cost of these sessions out-of-pocket, as she doesn't have a MHCP and therefore can't claim a Medicare rebate.

Over several weeks, Jane works with her psychologist on her feelings of hopelessness, but they're not significantly improving. She's also starting to worry about the cost of the sessions, as they're becoming financially burdensome.

In the second scenario, John is experiencing similar feelings of hopelessness. Instead of seeking a psychologist directly, John decides to first visit his GP. The GP assesses John's mental health, discusses his symptoms, and together they develop a MHCP. The GP also refers John to a psychologist.

With the MHCP in place, John can claim a Medicare rebate for his psychology sessions, significantly reducing his out-of-pocket expenses. His GP and psychologist also communicate about his care, ensuring a coordinated approach to manage his feelings of hopelessness. Over several weeks, John's feelings start to improve, and he feels supported by his healthcare team.

These scenarios illustrate that while you can see a psychologist directly without a GP referral or a MHCP, doing so may mean you miss out on the benefits of a coordinated healthcare approach and the financial relief offered by the Medicare rebate system.

Understanding the Mental Health Care Plan

A MHCP is a structured framework developed collaboratively by you and your GP. It outlines the treatment and support services you need to address your mental health issues. The plan may include referrals to psychologists or other mental health professionals, medication management, and lifestyle changes. The development of a MHCP involves reviewing your mental health condition, identifying your needs, setting treatment goals, and deciding on the treatment strategies.

The Medicare Rebate and Psychologist Fees

Psychological services can be costly, and this is where the Medicare rebate comes into play. Under the Medicare Benefits Schedule (MBS), if you have a MHCP from your GP, psychiatrist, or paediatrician, you are eligible for a Medicare rebate for a certain number of sessions per calendar year which at the time of writing is up to 10 individual sessions per calendar year.

The rebate does not cover the full cost of the session, but it significantly reduces your out-of-pocket expenses. The remaining fee, known as the 'gap payment', will vary depending on the psychologist's fees.

Conclusion

So, while you do not technically need a referral to see a psychologist in NSW, obtaining a MHCP from a GP can be beneficial, particularly for making psychological services more affordable through the Medicare rebate. It's advisable to speak to your GP if you're considering seeking help from a psychologist, not just for potential cost benefits but also to ensure a coordinated and comprehensive approach to your mental health care.

Footnotes

1. Psychology.org.au. Referral to a psychologist. Australian Psychological Society. Retrieved from https://www.psychology.org.au/for-the-public/about-psychology/what-psychologists-do/Referral-to-a-psychologist ↩
2. Healthdirect.gov.au. Mental health care plan. Healthdirect Australia. Retrieved from https://www.healthdirect.gov.au/mental-health-care-plan ↩
3. Ibid. ↩
4. Servicesaustralia.gov.au. Help with the costs of seeing a doctor. Services Australia. Retrieved from https://www.servicesaustralia.gov.au ↩
5. Healthdirect.gov.au. General practitioners (GPs). Healthdirect Australia. Retrieved from https://www.healthdirect.gov.au/general-practitioners ↩
6. Ibid. ↩
7. Ibid. ↩
8. Servicesaustralia.gov.au. (2021). Help with the costs of seeing a doctor. Services Australia. Retrieved from https://www.servicesaustralia.gov.au ↩