Public Health Care vs Private Health Care for Mental Illness.

This is an emotionally charged topic for me, but I will try to do my best to put forward a balanced view.

To start with I should mention that being admitted to hospital when you are severely depressed or manic, whether it be public or private is of course terribly stressful and unpleasant.   Being in hospital for weeks or months on end is furthermore, terribly stressful and unpleasant, whether or not it is in a public or private hospital.  The difference between the two is the fine line between bearable (private) and NOT bearable (public), and in my experience the difference between getting better in hospital and going home in a better frame of mind (private) vs just biding your time in hospital and pulling it together enough that they let you out – only to find you fall apart again as soon as you get home (public).  This doesn’t change the fact that you can still relapse after a stint in a private hospital, it is just that the likelihood is lower.

I also understand that the public system is not equipped with the facilities, funding or training that the private system has.  So really you’re not comparing apples with apples.  Each have their own place in society – I am writing this post though to alert you to the fact that getting private health insurance might be more of a priority for you than what you realise.  Personally I would pay for my private health insurance before I would pay for other essential items/bills and when we were on the brink of bankruptcy this is exactly what I did, thankfully.  Now to get into it:

In the beginning when my major depressive episode was just starting, we used the public health system.  The first time was as a result of a suicide attempt and the ambulance took me to the public hospital for treatment.  Once I was treated for the overdose I had taken, I was moved to the emergency mental health area, where I stayed for more than 5 hours without being seen by a doctor or nurse and without being offered any treatment, let alone food or drink.  It was very scary for me because other people waiting were outwardly psychotic and/or behaving very strangely and even aggressively and this of course frightened me.  On top of that, I was extremely stressed by the possibility of being ‘locked up’ in the hospital for an extended time.  To top it off there was no smoking area, and being a smoker this just tipped me over the edge.  My husband was also extremely stressed during this time because no one would speak to him about my treatment or DO SOMETHING to get me seen quicker and we were not allowed to leave.  In the end I did get ‘locked up’ but it was in a fairly nice ward, with other patients similar to me.  I wasn’t there that long but it wasn’t too bad, except for the fact that you very rarely saw a doctor and the nurses were run off their feet, so could only give you small snippets of their attention.

At a later date, when I again attempted suicide, we went once more to the public hospital and through the emergency mental health area, and had similar experiences to the time before, except it wasn’t as scary this time because I knew what to expect.  The problem came when they decided to put me in a different ward to the last time, one with lots of people much more psychotic than I was and the ward itself was atrocious.  In the toilet/shower area for example there were faeces smeared on the wall and floor for days on end.  I had to share a room with three other people who suffered very different conditions to mine – eg schizophrenia.   It was terrifying and I went into total shut down.  My husband, seeing the condition I was in and the condition of the ward, went into overdrive to have me discharged from the hospital as he could see that it was doing more damage than good for me.  He had A MAJOR problem getting me discharged, it took him more than 24 hours and innumerable phone calls to the hospitals management to finally have me discharged.  We swore that from then on we would NOT use the public mental health system.  In the end he had to agree to have me admitted to a private hospital immediately after my discharge from the public hospital in order for them to discharge me – which is exactly what he did.

I can’t say for sure that this type of scenario is still the case in the public health sector, this story goes back a few years now and they are of course improving the system all the time but at the time it was not suitable for me, even though it was free.  I am very lucky to have the ability to pay for private health insurance and so we then began to use the private health service instead.

We have found that the private health system still has long waiting periods, staff run off their feet and general chaos, but you always get to see a doctor within a reasonable time, you have the nurses checking on you more often, it is clean and homely in the wards and you get your medications on time, every time.  It is also good being in a private hospital that only deals with mental health, that is a specialist hospital like the one I go to.  Every staff member is trained in mental health issues and all the patients there are getting the treatment they need.  You are put in rooms thoughtfully – taking into consideration the mental health concerns of each of the people sharing that room and there are areas you can go to escape your room, in my case there was a TV room, a gym, an outdoor area (where you can smoke), a nice eating area etc.  That is another definite distinction between the public and private health sectors, food – the food in the public health system was terrible, the food in the private hospital I went to was incredibly good, I actually missed the food when I was discharged!

It helps me too that my Psychiatrist has admitting rights at my hospital of choice and I can therefore see him in person whenever I need to be admitted.  He also administers the ECT (electroconvulsive therapy) at the hospital another service I have used and written about in other posts.

The downside of the private health system is that you often have to wait a few days before you are admitted, you cannot go to the hospital for emergency treatment – for that you still have to go to a ‘normal’ non specialist hospital.  We did this on a number of occasions when I attempted suicide we would go to a ‘normal’ private hospital for emergency treatment and I would stay in that hospital until I could be transferred to my specialist hospital, care of my psychiatrist who has admitting rights.  This means you have to pay two excesses on your private health insurance one for the first hospital you’re admitted to and another one for the second one.  But most private health insurance has excess caps per annum so this is only a problem for the first two times you have to go into hospital each year for example.  It is a good idea if you are living with bipolar to keep a few thousand dollars in the bank ready to pay your private health insurance excesses when/if you need to be admitted to hospital.  The other downside of private health insurance is that you have to pay for it each month – but if you do, it decreases the amount of tax you have to pay each year, so it all balances out in the end.

So in summary, if you can afford private health cover DO IT, you can’t afford not to have it, in my opinion.

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