People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.

But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.

If you can’t get in to see a psychiatrist and you need help, there are some other options. However in an emergency, you should call 000.

Why do people see a psychiatrist?

Psychiatrists are doctors who specialise in mental health and can prescribe medication.

People seek or require psychiatry support for many reasons. These may include:

• severe depression, including suicidal thoughts or behaviours
• severe anxiety, panic attacks or phobias
• post-traumatic stress disorder (PTSD)
• eating disorders, such as anorexia or bulimia
• attention deficit hyperactivity disorder (ADHD).

Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available a range of team members can contribute to a person’s mental health care.

Can my GP help?

Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.

GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behaviour.

The GP Psychiatry Support Line also provides doctors advice on care, prescription medication and how support can work.

It’s a good idea to book a long consult and consider taking a trusted person. Be explicit about how you’ve been feeling and what previous supports or medication you’ve accessed.

What about psychologists, counsellors or community services?

Your GP should also be aware of supports available locally and online.

For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment and access to treatment.

Medicare Mental Health Centres provide in-person care and are expanding across Australia.

There are also virtual care services in some areas. This includes advice on individualised assessment including whether to go to hospital.

Some community groups are led by peers rather than clinicians, such as Alternatives to Suicide.

How about if I’m rural or regional?

Accessing support in rural or regional areas is particularly tough.

Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.

Should I go to emergency?

As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.

But going to a hospital emergency department will be essential for some who are experiencing a physical or mental health crisis.

Managing suicide-related distress

With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.

Roughly nine Australians die by suicide each day. One in six have had thoughts of suicide at some point in their lives.

Suicidal thoughts can pass. There are evidence-based strategies people can immediately turn to when distressed and in need of ongoing care.

Safety planning is a popular suicide prevention strategy to help you stay safe.

What is a safety plan?

This is a personalised, step-by-step plan to remain safe during the onset or worsening of suicidal urges.

You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.

Safety plans usually include:

1. recognising personal warning signs of a crisis (for example, feeling like a burden)
2. identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
3. seeking social supports for distraction (for example, visiting your local library)
4. letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
5. knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
6. making the environment safer by removing or limiting access to lethal means
7. identifying specific and personalised reasons for living.

Our research shows safety planning is linked to reduced suicidal thoughts and behaviour, as well as feelings of depression and hopelessness, among adults.

Evidence from people with lived experience shows safety planning helps people to understand their warning signs and practice coping strategies.

Are there helplines I can call?

There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):

Suicide helplines:

• Lifeline 13 11 14
• Suicide Call Back Service 1300 659 467

There is also specialised support:

• for men: MensLine Australia 1300 78 99 78
• children and young people: Kids’ Helpline 1800 55 1800
• Aboriginal and Torres Strait Islander people: 13YARN 13 92 76
• veterans and their families: Open Arms 1800 011 046
• LGBTQIA+ community: QLife 1300 184 527
• new and expecting parents: PANDA 1300 726 306
• people experiencing eating disorders: Butterfly Foundation 1800 33 4673.

Additionally, each state and territory will have its own list of mental health resources.

With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.

Monika Ferguson, Senior Lecturer in Mental Health, University of South Australia and Nicholas Procter, Professor and Chair: Mental Health Nursing, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.

Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of both type 1 and type 2 diabetes.

More people became aware of this condition after Lance Bass, best known for his role in the iconic American pop band NSYNC, recently revealed he has it.

So, what is type 1.5 diabetes? And how is it diagnosed and treated?

There are several types of diabetes

Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually more than ten types of diabetes, but the most common are type 1 and type 2.

Type 1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.

Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need insulin medication daily. Type 1 diabetes usually appears in children or young adults.

Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to overcome this resistance. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.

Type 2 is more common in adults but is increasingly seen in children and young people. Management can include behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.

How does type 1.5 diabetes differ from types 1 and 2?

Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin immediately because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within five years of diagnosis, while those with type 1 typically require it from diagnosis.

Type 1.5 diabetes is usually diagnosed in people over 30, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.

Type 1.5 diabetes shares genetic and autoimmune risk factors with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as obesity and physical inactivity which are more commonly associated with type 2 diabetes.

What are the symptoms, and how is it treated?

The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following symptoms:

• increased thirst
• frequent urination
• fatigue
• blurred vision
• unintentional weight loss.

Typically, type 1.5 diabetes is initially treated with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.

When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are no universally accepted management or treatment strategies for type 1.5 diabetes.

Type 1.5 diabetes is often misdiagnosed

Lance Bass said he was initially diagnosed with type 2 diabetes, but later learned he actually has type 1.5 diabetes. This is not entirely uncommon. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes 5–10% of the time.

There are a few possible reasons for this.

First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special antibody tests (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.

Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).

Third, people with type 1.5 diabetes often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.

Finally, because type 1.5 diabetes has symptoms that are similar to type 2 diabetes, it may initially be treated as type 2.

We’re still learning about type 1.5

Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in non-European populations. In 2023, it was estimated type 1.5 diabetes represented 8.9% of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.

Overall, there has been a limited awareness of type 1.5 diabetes and unclear diagnostic criteria which have slowed down our understanding of this condition.

A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.

Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce diabetes distress. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.

Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.