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Peer support is when people give or receive support based on shared experiences of mental health concerns. Peer support relationships are different from traditional clinician-patient relationships and are not based on medical models. Instead, peer support provides mental health benefits through empathy, acceptance, and skill-sharing that comes from dealing with similar lived experiences.
There is limited evidence that peer support reduces mental health symptoms. However, it can still be an important tool in recovery. Receiving peer support has a range of possible benefits for people with mental health issues, including (1-3):
The person giving peer support can also be helped by the process. People providing peer support describe:
A peer support relationship can be one person supporting others emotionally, socially, or through their shared lived experience. It can also be mutual, where each person involved is giving and receiving support.
Peer support is often provided professionally in mental health services. However, a lot of peer support happens informally, between people who share similar experiences and connect in person or online.
Peer support does not replace other mental health support from psychologists, counsellors, or psychiatrists. However, it is often used alongside other mental health services, empowering people to lead fulfilling lives and manage mental health challenges.
People do not need to share the same mental health diagnosis for peer support to work. Instead, the benefits come from having faced similar (but not necessarily the same) challenges.
Peer support can be delivered in a range of ways, in person, over the phone, or online. Peer support can be one, or a combination, of the two categories:
Informal peer support is a mutual relationship between people who have similar experiences. There are not necessarily any guidelines or trained group facilitators, and there may be no mental health services involved. This could take place on social media groups, common interest meet-ups, blogs or Forums.
A professional Peer Support Worker will have training in how to use their mental health experience intentionally to support others safely, in groups or one-to-one. They may have additional training in group facilitation, mental health support, and assisting people who've been through trauma.
Peer Support Workers aim to support people wherever they are in their recovery, and to focus on a person's strengths.
To explore if peer support will be helpful, think about what would suit you best. You may feel more comfortable depending on whether you are meeting one-to-one or in a group, and whether support is face-to-face or online.
It is also important to think about what you feel comfortable sharing and whether hearing other peoples’ experiences will be helpful right now, or if it might be upsetting. Peer support will not suit everyone all the time, and that is normal.
When searching for peer support, keep your safety in mind. Look for groups, services, and communities that:
For help finding the right support for you, contact a trusted GP, mental health professional, or helpline to talk through options.
Peer support can be an important part of mental health recovery, increasing hope, quality of life, and empowering people to manage their mental health.
To discover more ways of connecting with others with shared experience, explore SANE’s range of peer support services, for anyone with mental health challenges or concerned about someone.
Dialectical behaviour therapy (DBT) is a modified version of cognitive-behavioural therapy (CBT) designed to treat borderline personality disorder (BPD). It can also be used to treat other conditions, like suicidal behaviour, self-harm, substance use, post-traumatic stress disorder (PTSD), depression and eating disorders.
The term ‘dialectical’ means ‘working with opposites’. DBT uses seemingly opposing strategies of ‘acceptance’ and ‘change’. The therapist accepts you just as you are, but acknowledges the need for change in order for you to recover, move forward and reach your personal goals.
During a course of DBT, the therapist works with you to help you move away from harmful coping behaviours and towards a life that you find personally meaningful and fulfilling.
DBT involves developing two sets of acceptance-oriented skills and two sets of change-oriented skills.
Learning how to focus your awareness on the present moment, and to acknowledge and accept your thoughts, feelings, behaviours and bodily sensations as they occur, without the need to control or manipulate them.
Related: Mindfulness
Learning how to manage and cope during a crisis, and to tolerate distress when it is difficult or impossible to change a situation. Learning to accept any given situation just as it is, rather than how you think it should be, or want it to be. Learning new skills like distraction and self-soothing, for both coping with and improving distressing moments.
Learning how to effectively manage your emotional experience, and not allow your emotions to manage you.
Learning assertiveness strategies to appropriately ask for what you want or need. Learning how to say no, and how to manage interpersonal conflict in a way that maintains respect for yourself and others.
DBT is typically run as a 24-week program, often taken twice to create a one-year program. In its standard form, there are three ways you receive DBT during the program. There are also shorter versions of DBT such as 12 week courses depending on the setting, and some versions do not include telephone coaching. DBT has been adapted for different needs.
A group facilitator teaches specific skills in a classroom setting, and sets tasks for the group members to practise between sessions. The skills training group typically meets once weekly, usually for around 2½ hours, across the 24-week program.
Running at the same time as the group, individual therapy typically occurs weekly to enhance your motivation and commitment to the program. It’s also an opportunity to discuss and apply specific DBT skills to your current everyday life.
On-the-spot telephone coaching from your therapist can be available at times during the week when you’re struggling. Your therapist guides you and encourages you to apply your new DBT skills to address and manage your issues.
In most Australian states, DBT programs can be accessed through both the public and private mental health system.
Some hospitals may run public DBT programs. Talk to your case manager, mental health professional or GP about referral options.
Private DBT programs require payment. Prices will vary depending on the specific service you choose. If you have private health insurance, check that it covers psychiatric admissions.
If you don’t have private health insurance but you’re eligible for the National Disability Insurance Scheme (NDIS), you may be able to allocate funds to access a DBT program within the private system.
To join a private DBT program, a psychiatrist from the specific hospital or clinic can provide a referral for you.
To find services providing BPD treatment in Australia or New Zealand, visit Project Air Strategy’s Service Directory.
For state-based mental health assistance:
This SANE factsheet was reviewed by industry professionals.
This SANE resource was created with support from The Vizard Foundation.
In Australia, there are circumstances where you can be legally hospitalised for a mental illness without your consent. You can also be legally compelled to receive treatment — medication and/or therapy — without your consent.
During an episode of mental illness, you may become sick enough to need hospital treatment. If you know you need urgent help you can ask to be hospitalised, but there are also circumstances where you may be legally hospitalised without your consent.
This isn’t rare: in 2014–15, just under a third of all mental health-related stays in Australian hospitals with specialised psychiatric care were involuntary. That’s 48,857 hospital stays.
The laws covering involuntary hospitalisation vary from state to state, but generally, you can only be hospitalised involuntarily if you’re judged to meet all of the following criteria:
and one or both of these criteria:
Once you reach hospital, one or sometimes two doctors will need to assess your mental health and agree that you need to be hospitalised without your consent.
The length of time you can be held, who can extend that time and who can review your case varies by state and territory.
A Treatment Order (sometimes called an Involuntary Treatment Order, a Community Management Order, a Treatment Support Order or a Community Treatment Order) is a legal order making it mandatory for you to take medication and engage in therapy or other treatments, whether you’re in a mental health facility or living in the community.
The laws for Treatment Orders vary by state, but generally speaking, a mental health professional can apply for an order, which must then be approved by a legal authority such as a magistrate or tribunal.
There are strict requirements for the granting of a Treatment Order. They are usually only granted where there is a risk of severe decline in your health, or a risk to your or someone else’s safety.
Treatment Orders are more common in Australia than in many parts of the world, and more common in some parts of Australia than others. For example, 99 out of every 100,000 Victorians was under a Treatment Order in 2010–11; in Tasmania it was 30 out of 100,000.
Even when you’re not making decisions for yourself, you still have legal rights. Each state and territory has legal aid and advocacy services to help you understand your rights in relation to your mental illness and treatment.
ACT • NSW • NT • QLD • SA • TAS • VIC • WA
This SANE factsheet is currently being reviewed by industry professionals, carers and people with lived experience of BPD.
AIHW, Specialised care characteristics, accessed 3 April 2017.
Light, E., Kerridge, I., Ryan, C., Robertson, M. (2012), Community treatment orders in Australia: rates and patterns of use. Australasian Psychiatry. 20(6), 478-482.
Treatment for mental health issues, trauma, and distressing experiences can include psychological treatments, medication, support in the community, or a combination of these.
Psychotherapy helps by giving an opportunity to talk to a specially-trained health professional in order to understand your symptoms, and to help you adapt how you feel, think and act in response to them.
Psychotherapy helps you to understand why you feel, think and act in ways which are distressing and affect your life, and to work towards changing these. This can be challenging but it means you play an important part in your own therapy, and this in itself is empowering.
Psychotherapy does not work quickly, but over a period of months will help you to learn new ways of thinking, behaving and even feeling. You may notice, for example, that you are better prepared to handle things that used to worry you or get you down. Eventually you may find the whole way you think of yourself and the way you perceive and respond to the world changes for the better.
Psychotherapy is often effective on its own for people with depression and anxiety disorders. Sometimes it is also useful to combine therapy with other treatments. For people with illnesses such as schizophrenia and bipolar disorder, for example, medication, ongoing rehabilitation, accommodation and employment support are often needed.
There are many types of psychotherapy which are proven to be effective. These may be provided individually, as part of a group, as a couple or even as a whole family – depending on the nature of the problem.
Some common therapies are:
CBT helps people discover how their feelings, thoughts and behaviour can get stuck in unhelpful patterns. They are encouraged to try new, more positive ways of thinking and acting. Therapy usually includes tasks to try between sessions. CBT is a well-established treatment for depression and most anxiety disorders. It can also be an effective part of treatment for other conditions, including post-traumatic stress disorder (PTSD), eating disorders, bipolar disorder and schizophrenia.
IPT looks at the way someone has related to significant people in their life, and how this may have affected other relationships and how they feel, think and act generally. It then looks at finding more positive ways of interacting with others. IPT can been especially effective in treating depression and anxiety disorders.
DBT is a form of treatment specifically for people with borderline personality disorder (BPD). DBT is based on an understanding that a key problem for people with BPD is extreme difficulty in handling emotions, and the distress associated with this. DBT helps people learn to handle their emotions better and re-learn the way they typically respond to situations and other people. DBT generally combines individual and group therapy. Read more on our factsheet about DBT here.
These treatments aim to support families and other carers by fostering calm and constructive family relationships where a member of the family has a psychotic illness such as bipolar disorder or schizophrenia. Family intervention sessions typically focus on education about mental illness, solving of problems encountered as a result of the illness, and improving communication and relationships where these are strained or stressful. Family interventions can reduce relapse rates for people with psychotic illness while also supporting everyone involved.
Psychotherapy varies in the length of time it takes to work, depending on the particular treatment and the person’s needs. The benefits of therapy often happen at a different rate for different people. Sessions usually last between 45 and 90 minutes. Most people receive up to ten sessions, with some attending further sessions if required.
A GP is always the best place to start if concerned about your physical or mental health. As well as making an assessment and diagnosis, a GP can prescribe a Mental Health Care Plan, which may include referral for psychological treatment to a psychiatrist, psychologist or other mental health professional. With a referral from a GP, the cost of this treatment is largely covered by Medicare. Health professionals at Community Mental Health Services and public hospitals do not charge fees
Psychiatrists are medically qualified doctors who specialise in the study and treatment of mental illness. They can therefore prescribe medication as well as provide psychological treatments.
A psychologist is a health professional trained to provide treatments to people with emotional and mental health problems.
Other mental health professionals may also be able to provide psychological treatments: for example, social workers and occupational therapists who have received specialised training.
Use these tips to get what you need.
As well as your GP, ask other health professionals, local pharmacists or trusted family and friends about providers of psychotherapy they would recommend.
The APS has a referral service that gives contact details of privately-practising psychologists in your area who work with particular mental health problems.
It’s important to be engaged as much as possible yourself in the psychotherapy. When making an appointment, or during an early session, ask the provider what the goals of therapy are and what it will involve.
The more you speak out and are frank with yourself as well as with the person providing the treatment, the more successful it is likely to be. If you feel concerned, confused or uncomfortable with the treatment, let the provider know, so they can work with you to address the reasons for these feelings. If you feel that they are not the right person to help you, then explain this and ask for another referral. A good therapist will want what is best for you and will not hesitate to refer you to someone more appropriate.
Ask your doctor about any concerns you have, or contact the SANE Helpline 1800 18 SANE (7263).
SANE also produces a range of easy-to-read publications and multimedia resources on mental illness. For more information related to this topic see:
Being physically active has many physical, mental and emotional benefits.
Related: Healthy living • Ten tips for sleep hygiene
Eating fresh, healthy food is important for our mental as well as physical health. Evidence is poor, however, that consuming herbs or other substances makes a significant difference to the symptoms of mental illnesses.
Related: Mental health in music - Mindfulness factsheet
Yes, mental illness can be treated. This means that many people who have a mental illness, and are treated, recover well or even completely. However, because there are many different factors contributing to the development of each illness, it can sometimes be difficult to predict how, when, or to what degree someone is going to get better.
When you or someone you know starts to feel mentally unwell, the first step in obtaining treatment is to see a doctor or other health professional for diagnosis. After a thorough assessment, a doctor can make a diagnosis based on a particular pattern of symptoms. A decision can then be made about the best treatment for these symptoms and their underlying causes.
Treatment means all the different ways in which someone with a mental illness can get help to minimise the effects of the illness and promote recovery.
It can involve psychological therapy, medication, and various supports in the community, as well as people with the mental illness helping themselves.
Further information about these different approaches is available in the Guide (see tab above).
These days, clinical treatment generally takes place in the community rather than in a hospital. Anyone who has been diagnosed with a mental illness which needs treatment, should be able to receive a range of clinical services in their own community. If necessary, ongoing support can be provided by a community mental health service clinic, where there are a range of mental health professionals.
There are lots of things that people with a mental illness can do for themselves, to help recover a balanced life. Healthy eating, getting plenty of sleep, and regular physical activity are all important to good mental health. Learning skills which help deal with stress, feeling down, relationships or the symptoms of the illness, are also ways in which someone with a mental illness can look after themselves.
If you have any concerns about your treatment speak to your doctor.
Antipsychotic medication refers to a few types of medication that can reduce symptoms of psychosis, like hallucinations and delusions. They also help prevent those symptoms from returning.
These medications work on brain chemistry – neurotransmitters that influence thoughts, mood and emotions.
Antipsychotic medication is often used for the treatment of schizophrenia spectrum disorders, but can also be used as part of treatment for other mental health issues. They can be used alongside other forms of help such as psychological therapies or community support.
Antipsychotic medication can be life-changing for some people, although it may not suit everyone. It is ok if you need, or want to try, medication for your mental health.
Antipsychotic medications are considered a front-line treatment for psychosis. They can be prescribed for an episode of psychosis, or as part of longer-term treatment. They help reduce symptoms such as delusions and hallucinations, and can also help with mood, memory, planning, and other thinking problems. Antipsychotic medication can also be helpful in the treatment of other mental health issues, such as bipolar disorder and depression.
They are not addictive, do not make you euphoric, or change your personality. All antipsychotic drugs are designed to do the same thing — reduce psychotic symptoms and keep them away. However, they’re known to affect people in different ways, so your experience of taking them will be unique to you.
Antipsychotic medication can be prescribed alone, or with other medications. Many people use antipsychotic medication to feel more stable and find it helps them engage with other support services. People often use them alongside other forms of help like psychological therapies, support with housing and employment, physical and occupational therapy, and more.
Antipsychotic medication is generally effective. Most people with psychosis have fewer symptoms after starting medication.
Antipsychotic medication is prescribed by a medical doctor (a GP or a psychiatrist). A doctor can discuss options for you, and prescribe you a dosage that they feel matches your symptoms and circumstances.
Different medications work for different people; you and your doctor can talk over to help decide which is most likely to be right for you. While there is usually a period of trial and adjustment, there are some things that can be worth discussing to help decide on a treatment plan:
There are two ways to take antipsychotic medication: by mouth or as a depot (sometimes called a ‘long-acting injectable’).
Depots are used if there are challenges swallowing medication. They are also used if there’s a risk of forgetting or stopping taking medication, which can lead to a rapid worsening of symptoms. You can choose to take medication by depot. There are also circumstances where a doctor can legally require someone to take medication by injection, even without consent. That’s only done rarely, and always with health and safety in mind.
It can take several weeks, or even a few months, after the first dose of medication before it has an effect. Checking in with your doctor over time can help keep an eye on how you’re going, and monitor any side effects.
If you have any challenges – such as struggling to remember to take medication – it important to raise these with your doctor.
Choosing the best medication is not always straightforward because the way people respond to medication is different. This means that finding the right one for you may involve trying one or more types, or making adjustments.
Antipsychotic medication is often long term. Many people with psychosis need to take medication as prescribed on an ongoing basis to ensure their symptoms don’t return.
When medication starts working and symptoms reduce, people can be tempted to stop taking it. Some people may also want to stop taking medication due to side effects. Others might find that memory problems, or the symptoms of psychosis interfere with their decision-making.
Before stopping or reducing any medication it is important that you discuss with a doctor. They can help with decisions about the best path forward. Stopping antipsychotic medication suddenly can cause problems, and lead to a return of psychosis. So any changes need to be done step-by-step under your doctor’s supervision.
If you’re taking antipsychotic medication, it’s very likely you will experience some side effects. Work is being done to improve medications, but at the moment it’s often necessary to weigh up the benefits of medication against how side effects might impact you
It’s important to tell a doctor about side-effects as soon as possible, and discuss any concerns.
For some people, it can take months to find the right medication — that’s normal.
If the side-effects of the medication you’re taking are too severe, or if your psychotic symptoms don’t subside, it might be possible to try other options.
To learn more, a GP or psychiatrist can provide a personalised discussion about whether antipsychotic medication is the right option for you.
‘Mental health’ involves psychological, emotional, and social wellbeing. Mental health affects thinking, moods and emotions, actions and behaviours, and relationships.
Good mental health involves being able to manage day-to-day stress, and to deal reasonably well with the challenges life throws at us from time to time. It means experiencing satisfaction and pleasure in everyday life. It’s also normal to feel sad, lonely, angry, disappointed, or confused at times. These feelings are part of being human.
People use different language to describe challenges with their mental health and emotional wellbeing. At SANE, we usually use the term ‘mental health issues’, but related terms include ‘mental ill-health’, ‘mental illness’ or ‘mental disorders’. We usually use ‘person with lived experience’ when referring to people who are affected by mental health issues. We acknowledge and respect that everyone has their own preferred language to describe their experiences.
It's estimated that around one in five Australians experience mental health issues every year (1)(1). Many people experience mental health issues like depression and anxiety disorders at some time in their life. Mental health issues can involve symptoms and experiences such as:
At SANE, we focus on supporting people are affected by ‘complex mental health issues’. This includes people who are affected by:
It’s estimated that around 800,000 Australians experience complex mental health issues, or around 3% of the population (2).
People who experience complex mental health issues might experience symptoms and challenges like those described above. But they might be more challenging to manage, or impact on their lives in a more significant way. They may also experience certain types of symptoms like trouble managing strong and intense emotions, unusual beliefs or behaviours, and the impacts of trauma.
Some people with complex mental health issues identify with one or more diagnoses such as:
SANE also supports people who experience co-occurring conditions such as autism, ADHD, or intellectual disability, and who also experience mental health issues.
Many mental health issues are first experienced in the late teens or early twenties, but they can also emerge later in life.
Most mental health issues are caused by a combination of genetics, life experiences, and lifestyle factors. It is difficult to predict who will experience mental health issues, as everyone is different. Factors can include:
Complex mental health issues vary in how long they affect people: sometimes people experience symptoms only once, whereas for others they can be recurring or a lifelong condition. They also vary in severity, as sometimes they can be mild and other times affect people significantly, across many areas of their life.
Complex mental health issues can involve long-term challenges. Many symptoms can be distressing and difficult to manage at times, and can impact on mental wellbeing, quality of life, physical health, and relationships with others. Sadly, there is also a lot of misunderstanding and stigma in the general community about complex mental health issues. Getting access to the right treatment and support, at the right time, can be difficult.
Still, many people living with complex mental health issues are able to thrive. With the right support, it is possible to manage symptoms well, predict or prevent flare-ups or episodes, and live a long and fulfilling life.
‘Mental health recovery’ is not solely about eliminating symptoms. It’s also not about being ‘well’ versus being ‘unwell’. At SANE, we think of recovery as being about developing connections to others, feeling hopeful or optimistic about the future, and feeling a sense of empowerment.
Thankfully, there are many things which help people with mental health recovery. Many people learn how to manage their mental health through developing a routine, learning and practicing coping skills, and accessing information about mental health. Families, friends, and other trusted people also play a huge role in recovery.
Many people also benefit from accessing support from mental health professionals. Treatment and support options can include counselling and psychological therapies, peer support, medications, support in the community, and managing physical health problems.
See Facts & Guides for more information about treatments and support.
Sometimes a person may be showing signs of mental health issues, but chooses not to seek treatment.
There are a variety of reasons why this happens. The symptoms of psychotic illnesses such as Schizophrenia, for example, may involve delusions, hallucinations, and disturbance to thinking processes – these can make it difficult for the person to realise or acknowledge that they have a mental illness and need help. The person may have stigmatising attitudes towards mental illness, which make it difficult to acknowledge the need for help. Or they may accept they have an illness, but not want to take medication, with the possible side-effects involved.
Whatever the reason, it may be that you are feeling concerned about their mental health, distress, or abiilty to manage their daily life.
Encourage the person to access treatment on their own volition and with your support. Here are some strategies to make communicating your concerns easier and hopefully more effective:
If the person is still reluctant to acknowledge a problem or to see a mental health professional, ask what is stopping them. Once you know what they are worried about, work together to find solutions to overcome these barriers. For example:
Remember that if at all possible it is best for the person involved to voluntarily seek help.
Don’t worry if your first attempt to talk isn’t successful. An initial conversation may plant the seed of seeking help in the person’s mind. By showing that you care and are not going to judge them, they will be more likely to come to you when they do decide to seek help.
If there is outright resistance to the idea of getting medical help, talk to the doctor yourself to work out a plan. The doctor may be able to visit the person at home to make an assessment. If this is not possible, they should still be able to tell you where to get help and support – for the person as well as others who are worried.
Someone refusing to acknowledge a problem or accept treatment can place family members and friends under significant strain, especially if the person is experiencing active symptoms. Don't think you have to deal with this situation alone, contact local mental health services, a helpline or carer organisation for advice and support.