The GP visit

I sat in the GP carpark for fifteen minutes before going in. The sentence I eventually said was: "I think I'm depressed and I want a Mental Health Treatment Plan." She wrote it down before I'd finished the sentence.

Booking it

Three things to get right when you book:

• Ask for a long appointment. Standard GP slot is 10-15 minutes. Not enough. Ask for a "long appointment" or "level C" — usually 30 minutes, $90-$130 out of pocket after Medicare rebate.
• Pick a GP, not just any GP. Ask which of their GPs has an interest in mental health.
• Book in the morning. Depression is usually worse in the morning, which means the version of you the GP sees is the honest one.

What to say

Plain language. No hedging.

The opening sentence:

"I think I'm depressed. It's been about [number] weeks. I want a Mental Health Treatment Plan and I want to talk about whether medication is part of this."

Eight seconds. Things worth volunteering even if not asked:

• How long. "About two months" is different from "since Christmas".
• Sleep. Hours, quality, when you wake.
• Appetite. Up, down, gone.
• Alcohol. Honestly.
• Suicidal thoughts. If you've had any, even passing ones, say so.
• Family history.

If there's a thing you don't want to say in front of the screen, write it on a piece of paper and slide it across.

The Mental Health Treatment Plan

The MHTP is the Australian Medicare-funded mechanism that gets you to a psychologist at a heavy discount.

• Your GP writes a Plan in the appointment.
• The Plan entitles you to 10 Medicare-rebated psychologist sessions per calendar year. Six up front, then a review with the GP, then four more.
• The rebate is around $96 per session. Psychologist's actual fee is usually $200-$280, so you'll have a gap.
• Some psychologists bulk-bill, especially in regional areas. Ask reception when you book.

The Plan is just the gate. You still have to ring around. You don't have to use all ten sessions.

The medication conversation

Roughly half of men leaving a GP visit for depression leave with a script.

The most commonly prescribed first-line antidepressants in Australia are SSRIs. Two you'll likely hear:

• Escitalopram (Lexapro). Lower side-effect profile, common starting choice.
• Sertraline (Zoloft). Slightly broader profile.

Things to know:

• They take 4-6 weeks to work properly. The first 1-2 weeks you'll likely feel side effects before you feel benefit. This is when most men stop taking them. Don't.
• The first medication you try might not be the right one. About 60 percent of men respond to the first SSRI.
• Stopping suddenly is a bad idea. Taper under your GP's supervision.
• Sexual side effects are real and worth raising. Affect 30-40 percent of men on SSRIs.

The GP isn't trying to sell you medication. They're offering you a tool that, used alongside therapy, gives most men a much faster recovery curve.

What you walk out with

A good appointment ends with you holding three things:

1. A signed Mental Health Treatment Plan with a referral letter.
2. Either a script for an SSRI, or a clear "let's see how the next four weeks go and revisit".
3. A follow-up appointment booked in 4-6 weeks.

If you don't walk out with all three, ask before you leave.

Book the long one. Say the literal sentence. Walk out with the Plan.

Further watching

• The Myth of the Chemical Imbalance: What Causes Depression? Lost Connections Summary Part 1
• Not All SSRIs Are the Same — How to Pick the Right One