By the time her doctor told her she needed hospital treatment, Georgia Harraway-Jones had planned her suicide in detail.
The 20-year-old was diagnosed by her GP with depression, anxiety and an eating disorder two years ago.
But the diagnosis and referrals to specialists weren't the lifeline they should have been. Georgia discovered the waiting list to see a psychologist in Ballarat was 12 weeks. A visit to a different GP resulted in another referral, to another psychologist. This time, the waiting list was 10 weeks long. It took three months to see a dietitian, and four months to to see a psychiatrist.
"In that time, I felt like my eating disorder really tightened its grip around my throat," she told the Royal Commission into Victoria's Mental Health System on Wednesday.
I lost a lot of weight ... I was threatened with involuntary admission.
By June last year, Georgia's situation worsened and she relapsed, hard. This time, the difference between a three-month wait for a public hospital bed in Melbourne and getting in straight away was life and death.
"I was quite suicidal, I had a plan and all that, and I really wasn't eating, and I don't think I would have made it those three months if I had have waited; I honestly don't think I'd be here, so I'm very thankful for my mum and dad and their private health insurance, because I was able to go into the Geelong clinic where I stayed for 40 days as an inpatient."
The inquiry, which on Wednesday focused on access to the mental health system, heard that waiting lists remain a major barrier to Victorians accessing psychiatric services.
The inquiry heard from Professor Malcolm Hopwood, who leads a clinical unit at the Albert Road Clinic, a private psychiatric hospital in Melbourne.
Professor Hopwood said most psychiatrists had waiting lists of several weeks, and waiting that long for care was not appropriate for patients' health.
He said other barriers to access were the referral process itself, for patients who were particularly unwell, and the cost of psychiatric services.
The inquiry was told most patients would pay an out-of-pocket fee of $130-$200 for a consultation with a psychiatrist.
Most people would be unable to afford to admit themselves or a relative into private psychiatric care without private health insurance, Professor Hopwood said.
"The out-of-pocket bed day cost would be approximately $800-$900, which, over a two or three-week stay, would be financially intolerable for many people, so private insurance is central to the inpatient care."
The average length of stay was 20 days, he said.
About 80 per cent of patients he saw were suicidal at admission.
Mercy Mental Health services clinical director Associate Professor Dean Stevenson told the inquiry funding to community mental health services should be at least doubled to cope with demand.
"We know that we should be providing services to about 3 per cent of the population who would suffer with a very severe mental illness," he said. "We're probably reaching less than half of that, so there is this whole group of people out there in the community who aren't getting the services and the treatments that they require to manage and to assist them manage their severe mental illness."
However, he said that last year the government had increased funding to Mercy Mental Health, which had been "wonderful" and had illustrated what a difference funding could make.
"I came into the job as clinical director in 2005, and probably all the way up to 2017, it was always, 'What services are we going to reduce, how are we going to balance the books?'
"Whereas last financial year there was funding that was coming in, and suddenly it was, 'What sorts of services can we now develop to meet the needs of the community?' which is a very exciting place to be in and contrasts very starkly to the previous 15 years."
The state government directed $56.1 million to Mercy Health in 2018-19 to improve, expand, and better co-ordinate their mental health services.
"I think there's a realisation at a government level that mental health services are in a very, very bad shape and that the system is broken and it needs to be fixed."
The hearing continues.
If you or someone you know needs help, contact Lifeline on 131114 or Beyond Blue on 1300 224 636
- Tha Age