Who does what and how?
There are distinct levels of engagement with mental health treatment in Australia. As with physical health, who to see depends on the severity and complexity of the problem. Here I explain the titles and outline the roles. There's quite a bit of overlap so please take this as a very general overview.
Two of the titles are strictly regulated by the government. The others are a little looser but still adhere to industry standards. Let me explain.
Starting with the strictly regulated …
Psychiatrist
This is a medical doctor who has undertaken considerable further training to specialise in the diagnosis and treatment of mental and behavioural disorders. They typically work in medical settings and treat a wide range of conditions, from dementia and autism to psychosis and mood disorders. Psychiatrists utilise the full range of treatment options including medication, psychiatric and neurological assessments, pathology tests, and neuroimaging techniques (MRI, Brain stimulation, etc). Access to a psychiatrist is by GP referral only. Medicare rebates are available. There is limited cover by private health insurance.
Psychologist
Psychologists typically undertake a bachelor degree in psychology followed by 3 years post-graduate study including a masters degree in clinical psychology. They are able to assess, diagnose, and treat a wide range of conditions including ADHD, autism, personality & mood disorders, addictions, and phobias. Psychologists typically use talking, cognitive, and behavioural therapy (collectively known as psychotherapy). They are not able to prescribe medication but often work with GPs to use medication to support the psychotherapy. A referral is not needed to see a psychologist however to access Medicare rebates, a Mental Health Care Plan (MHCP) is required and can be obtained through a GP. There is limited cover by private health insurance.
The following titles are more loosely regulated …
Psychotherapist/Therapist
This is not a government regulated title but to obtain industry recognition, a psychotherapist is required to have undertaken considerable post-graduate study. This is typically a masters degree in psychotherapy or another specialist qualification. Psychotherapists sometimes work with psychiatrists and psychologists to deliver the therapy required by a diagnosis. They often work in private practice using a wide range of psychotherapies to treat mood & anxiety disorders, behavioural concerns, problems with grief & loss, addictions, and relationship & identity issues. Referrals are not required. Medicare rebates are not available. There is limited cover by private health insurance.
Registered Counsellor
The title counsellor is also not government regulated. However, to be registered, a counsellor must hold tertiary qualifications, the type of which is determined by the level of registration. Counsellors work much like psychotherapists but do not typically treat diagnosed mental illnesses. Their scope of practice includes mild to moderate depression & anxiety, grief & loss, relationship & workplace issues, and concerns around life transitions, self-image & core-belief. Counsellors typically use talk therapies and many specialise in particular fields, such as schools, workplaces, aged care, gender & diversity, and family services. Referrals are not required. Medicare rebates are not available. There is limited cover by private health insurance. Subsidised counselling is often available through Employee Assistance Programs.
In 2023, the federal government commissioned a report to investigate if and how counsellors and psychotherapist might be added to Medicare. This would make mental health care way more accessible, especially to people whose mental health is challenged not by a psychological disorder, but just by life's challenges. The report is due mid 2025. I'll keep you posted.