What’s the difference between a psychologist and a psychiatrist?

Here’s the low down on the difference between them, what to do if you think you might need to see one, and how to get a Mental Health Care Plan.

Your mental health matters

You wouldn’t hesitate to see your GP about a physical health concern. Seeking support to maintain your mental health is every bit as important, but should you see a psychologist or psychiatrist? And do they bulk bill? 

You’re not alone in wondering what the difference is between these two professions. With more than half of all Australian adults experiencing mental health issues at some point in their lives, and many people feeling stressed and worried in the wake of COVID-19, it’s important to understand the different kinds of support available to you through these two treatment pathways.

So, what’s the difference between a psychologist and psychiatrist?

Let’s start with the similarities – both psychologists and psychiatrists are trained to understand the workings of your brain − how you think and how you act. They each use forms of counselling and therapy to help you develop better ways of thinking and responding to life stresses.  A psychologist or a psychiatrist (sometimes both) can play an important role in helping someone to recover from or better manage mental health issues.

“Whether you choose to see a psychologist or psychiatrist, the important thing is to find a professional you connect with.”

First and foremost, the difference comes down to qualifications.

A psychiatrist is a medical doctor, a psychologist is not. Only a psychiatrist can prescribe medications and arrange hospital admissions. They have more than ten years of medical and specialised training in the diagnosis and treatment of mental health disorders.

A psychologist has a minimum of six years of training in the science of how people think, feel, behave and learn and is proficient in talk therapies. Clinical psychologists have additional mental health training for providing assessment and psychological treatment of mental, behavioural and emotional issues. To use the title ‘psychologist’, a practitioner must complete the required study, supervised practice and then become registered with the Psychology Board of Australia.

Psychologist vs. psychiatrist: there are also differences in approach

Psychology is the science of human behaviour. A psychologist can help you to gain insight into the challenges you face at work, at home and in society, by listening to your story and asking questions to identify solutions that will work best for you. They may teach you skills – like mindfulness – that you can use to better manage your emotions and reactions to stressful situations.

A psychiatrist uses their medical background to factor the big picture of your medical history into their diagnosis and can manage the treatment of mental illnesses and disorders using a range of therapies. They can determine or rule out whether physical health conditions are causing poor mental health, prescribe necessary medications and arrange a hospital admission if required. 

Psychiatrists can also perform interventions, like electroconvulsive therapy, which stimulate the brain.

How do I know which will best meet my needs?

Talking to your GP is the place to start. They will work with you to put a Mental Health Care Plan in place. This plan is strictly confidential and outlines your agreed mental health goals, including treatment options and support services. Your doctor can then provide you with a referral to the medical professional most suited to your needs.

Your doctor might recommend a psychologist for support if:

• you are struggling with anxiety or worry
• you want to change a habit or develop new coping strategies
• you want to gain a better understanding of yourself
• you feel like you’d benefit from talking to someone impartial about your problems.
  

Your doctor may refer you to a psychiatrist for mental health concerns such as:

• treatment of severe anxiety or depression
• diagnosis and treatment of complex and serious mental health conditions
• wanting to discuss or change medications
• experiencing suicidal thoughts or suicide attempts.

How many sessions will I need?

This depends on your personal goals. Often psychological treatment is a process that will take a number of sessions, over a period of several months or years. Under a Mental Health Care Plan, your GP can initially refer you for six subsidised sessions, and then you will need to return to reassess whether more will be necessary.

Consults with a psychiatrist for a specific need, such as modifying medication, may be less frequent.

Depending on your individual mental health, you may need to see both a psychologist and a psychiatrist for different purposes.

What does it cost?

Costs for a psychologist

Fees vary, so ask for this information upfront before you make a booking. The Australian Psychological Society (APS) publishes a recommended schedule of fees for psychologists who provide private services.  

Medicare will cover a substantial part of the cost per session (for up to ten sessions in a calendar year) once you have a Mental Health Care Plan in place and a referral from your GP. Some private practices will bulk bill automatically while others may if you ask. To receive the Medicare rebate on psychology sessions as part of a Mental Health Care Plan, you will need to meet one of these criteria.

If you choose to access a psychologist in a private practice outside of a Mental Health Care Plan, you can claim a benefit for treatment under your Extras cover, if it includes psychology. The psychologist must be registered in Australia for you to be able to claim benefits.

Costs for a psychiatrist

If you’re admitted to a public hospital for mental health treatment, psychiatrist treatment will be covered by Medicare at no charge to you. However, there may be a long wait before you can access inpatient treatment.

If you choose to be admitted to a private hospital for your mental health treatment, you’ll need to have the right type of Hospital cover to ensure you’re not faced with a large gap payment. Some levels of Hospital cover restrict psychiatric services, but in 2018, the Australian Government introduced a  once-per-lifetime waiting period waiver if you need to upgrade your cover to access higher inpatient psychiatric care benefits. You must have held continuous Hospital cover for two months to be eligible for the waiver.

If you’re expecting a hospital admission, contact your hospital and your doctor to obtain informed financial consent (likely cost of treatment). Then, contact CBHS to find out how much will be covered and how much the gap payment will be, if any.

Private consultations with a psychiatrist as an outpatient aren’t covered under any private health insurance, but you may be able to claim a rebate through Medicare. The Royal Australian & New Zealand College of Psychiatrists provides information about the cost of seeing a psychiatrist and how much the Medicare rebates are. Some psychiatrists will bulk bill, and it’s best to discuss your circumstances directly with the clinic. The RANZCP website has a ‘finder’ tool where you can search psychiatrists who bulk bill in your local area.

Additional COVID-19 mental health support is now available

From 9 October 2020 until 30 June 2022, the Australian Government is making available 10 additional Medicare-subsidised psychologist sessions in each calendar year for people experiencing severe or enduring mental health impacts as a result of the pandemic and restrictions. This is in addition to the standard 10 subsided sessions you can access as part of a Mental Health Treatment Plan.

Take advantage of this, under the Better Access Initiative, your GP can review your Mental Health Care Plan and refer you for the additional sessions you need (up to the current total of 20 per calendar year). Once you have exhausted all of your Medicare-rebate psychologist sessions, you will either need to pay full fees, or wait until the new calendar year begins to have your GP review your Mental Health Care Plan and possibly make more subsidised sessions available to you.

What if I still have questions?

Once you’ve taken the step to see a psychologist or psychiatrist, don’t be afraid to ask lots of questions, such as what they can do for you and what you can expect from your sessions together. It’s important that you have a good connection with them and being actively involved in your treatment process plays an important part in successful outcomes.

Need help urgently?

If you or someone you know is experiencing mental health issues and needs to speak to someone urgently, you can call:

Lifeline  13 11 14

SANE  1800 18 7263

Beyond Blue 1300 22 4636

Sources

https://www.healthdirect.gov.au/mental-health-and-wellbeing

https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/ongoing-support-during-coronavirus-covid-19/looking-after-your-mental-health-during-coronavirus-covid-19-restrictions

https://www.healthdirect.gov.au/psychiatrists-vs-psychologists

https://www.betterhealth.vic.gov.au/health/servicesandsupport/whos-who-in-mental-health-services

https://acpa.org.au/what-is-a-clinical-psychologist/

https://www.psychology.org.au/for-the-public/about-psychology

https://www.servicesaustralia.gov.au/individuals/subjects/whats-covered-medicare/mental-health-care-and-medicare

https://www.psychology.org.au/for-the-public/about-psychology/what-it-costs

https://www.yourhealthinmind.org/psychiatry-explained/cost-to-see-a-psychiatrist

https://www.health.gov.au/initiatives-and-programs/better-access-initiative?utm_source=health.gov.au&utm_medium=callout-auto-custom&utm_campaign=digital_transformation 

All information contained in this article is intended or general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.