City Hub

A new model for mental health care

Founder and director of Rough Patch, Amber Rules. Photo: supplied


A new counselling social enterprise in Leichhardt is pioneering a new model for mental health care in Sydney’s Inner West.

Rough Patch Affordable Counselling opened in Leichhardt in August and has been met with an enthusiastic reception from locals who’ve accessed its services.

Amber Rules, a psychotherapist who specialises in addiction recovery, is the founder and director of Rough Patch. She told City Hub the service is “filling a gap” in the mental health care market between full priced private health practices which can charge up to $250 an hour and free charity services.

“People who know what the mental health care landscape is like are quite relieved we exist,” she explained.

“A lot of people may be able to pay for one or two sessions at a full fee paying psychologist, but they just can’t afford to do it on an ongoing basis. And counselling takes time.”

Rough Patch’s model, based on a Canadian mental health provider, makes the service unique in Australia. As opposed to being a charity organisation, the service is a non-profit social enterprise. Meaning, while the business makes money, it goes directly back into improving the quality of services rather than into the pockets of shareholders. 

While very low cost or free counselling is available through some faith-based charities and local area health services like hospitals, there are often very long wait lists and the high demand means the service can be limited. Faith-based services are also not often the right fit for people. 

That’s where Rough Patch comes in, Ms. Rules said. 

“Often-times people are in a position where they can pay something, but they can’t afford what’s at the other end of the spectrum- which is full fee private practice, either counselling or psychology,” she said.

“There’s a big group of people in the middle, particularly people who understand a bit about mental health care and who do prioritise it, but they just can’t manage the full fee paying and they want to see someone weekly to get the support they know they need.”

The social enterprise provides mid-term counselling support for people who cannot afford market rate providers for which Medicare only rebates up to 10 sessions a year. Clients can take up to 15 sessions a year at Rough Patch and don’t need to provide proof of income to access the service. 

“One of our questions is, ‘would you be able to afford this counselling if it were market rate, if we didn’t exist?’. And the majority of our clients said no they wouldn’t have been able to,” she said. 

Ms. Rules said the model has been working well for the counsellors as well, who have access to more resources than they would at a charity clinic but don’t have to foot the bill for expensive rental costs they would at a private practice. 

“How’s your head today?”

Last week the Australian Government launched a COVID-19 mental health campaign, asking “How’s your head today?”, to encourage Australians to prioritise mental health and wellbeing. The campaign highlights coping mechanisms for everyday challenges Australians face including staying connected, building a daily routine and maintaining a healthy lifestyle. 

The campaign is part of the Australian Government’s $48.1 million support of the Mental Health and Wellbeing Pandemic Response Plan. 

At the campaign’s launch federal health minister, Greg Hunt, said Medicare statistics showed “a significant uptake of mental health telehealth services”. He noted the number of people seeking help for complex issues through mental health charities such as Lifeline and Beyond Blue had also increased.

“The pandemic has caused isolation, job losses and financial stress for many families, with crisis organisations and suicide prevention services experiencing higher demand,” Mr Hunt said.

But with the COVID-19 pandemic taking a serious hit on many family’s incomes, mental health care can sometimes be put on the back burner for financial reasons. 

“People can’t always prioritise mental health care because they have to do things like pay school fees or put food on the table,” Ms. Rules said. 

Ms. Rules said a diverse range of mental health services, at a range of price points, is especially important within the context of the ongoing pandemic. 

She said her experience of counselling in the wake of the COVID-19 pandemic is “all the normal stuff, but kind of on steroids”, with health, economic and isolation related concerns exacerbating existing worries or mental health issues people may have.

“If you’re a parent, for example, parenting issues have just intensified as people have been spending so much time with their kids, homeschooling and doing their jobs,” she explained.

“So it’s all the usual concerns, but just a lot more intense.”

Individual counselling sessions at Rough Patch vary in price $60 from $90 depending on the client’s circumstances. Ms. Rules hopes in future Rough Patch will be able to roll out group sessions to make the service even more affordable.

The clinic also has a shop on site that sells books, resources, self-care items and homewares with all proceeds going back into providing counselling and mental health programs in the community.

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