A Perth local who has spent six months looking for a psychiatrist says the only one who would accept them has quoted $1900 for a first appointment, and Medicare will cover only a small part of it.
The person says their GP referral listed complex trauma, depression and anxiety, and that about 20 public and private services turned them down before this one said yes. They described the hour-long appointment as a standard consultation, not an ADHD or autism assessment, and said they expected about $200 back from Medicare.
"This is the only one that has accepted me and I just don't know what to do." - Perth local
Everything Perth has not named the clinic or confirmed the quote with it.
What Medicare actually pays
A first visit to a private psychiatrist lasting more than 45 minutes is billed under Medicare item 296. The schedule fee is $316.30, and Medicare pays 85 per cent of that, or $268.90. Anything a specialist charges above that is the patient's gap.
Specialists are free to set their own fees, so a $1900 bill would leave a gap of more than $1600 on one visit. Locals who work in health told the person the figure was unusually high. Several said they had paid between about $700 and $1100 for a first appointment, and one said they paid $895 for a 40-minute review.
The Medicare Safety Nets can help people with high ongoing costs. Once your out-of-pocket spending on out-of-hospital services passes a yearly threshold, Medicare pays more back. For item 296, the extra Safety Net benefit is capped at $500 per visit. One local said the Safety Net brought their rebate up to 90 per cent while they were being treated for postnatal depression.
Photo: Kgbo via Wikimedia Commons (CC BY-SA 4.0). File photo, not connected to the clinic in this story.
Why complex patients get turned away
The bigger problem for the person was getting through the door at all. Locals who replied said private psychiatrists often turn down referrals that mention suicide risk or complex conditions, because they can't monitor a patient's safety between appointments. Others said they had been rejected by email without a phone call or screening.
A few suggested asking the clinic exactly what the fee covers, including any reports or letters, and asking up front how much follow-up visits will cost. The person said that was their biggest worry. They already see a psychologist every week, and regular psychiatrist visits at $700 to $900 each would be out of reach.
Free and low-cost options
Several locals pointed to free public services that can be used alongside, or instead of, private care:
- Community mental health services run by WA Health have psychiatrists, psychologists and social workers at no cost. One local said they were able to self-refer to their local clinic.
- Medicare Mental Health Centres are free walk-in services. You don't need a referral or an appointment.
- A GP mental health treatment plan gives you Medicare-subsidised sessions with a psychologist.
The person said they had already tried an emergency department and been discharged with a promise of follow-up that never came. They were still deciding whether to take the appointment.
If you need help now
If you or someone you know is in crisis, call 000. In WA, the Mental Health Emergency Response Line is available 24 hours on 1300 555 788 (metro) or 1800 676 822 (Peel), and RuralLink is on 1800 552 002. Lifeline is on 13 11 14, and the Suicide Call Back Service is on 1300 659 467.
Sources: Medicare Benefits Schedule item 296; Services Australia; WA Primary Health Alliance; HealthyWA; comments from Perth locals.
Main photo: Calistemon via Wikimedia Commons (CC BY-SA 4.0). File photo of Royal Perth Hospital, not connected to the clinic in this story.
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