A short page for the referring clinician.
Hard Conversations is a solo private practice for adult men — telehealth across Australia, mental health and sexual health in one practice.
Run by Ben Waters, registered psychologist (MProfPsych, AHPRA PSY0001961782). Based in Kiama Downs NSW; telehealth only.
The essentials.
- Who's seen
- Men 18 and over
- What's treated
- Mental health and sexual health, including the overlap
- Format
- 50-minute sessions via Zoom Workplace (clinical configuration)
- Medicare
- Telehealth covered under an MHCP, $98.95 rebate per session, up to 10 per calendar year
- Referrals
- Addressed to Ben Waters by name, or generically — patient's choice
- First step for the patient
- Free 10-minute intro call by phone, no commitment
- Communication back
- Standard MHCP letters at end of initial course and end of referral
Mental health and sexual health, deliberately together.
Mental health. Depression, anxiety, trauma, anger, fatherhood-related concerns, relationship difficulties, work and identity concerns, substance and behavioural concerns.
Sexual health. Erectile difficulties, premature ejaculation, low desire, performance anxiety, pain conditions, problematic porn use, sexuality and orientation concerns, sexual confidence, post-prostate-treatment concerns.
The two often overlap — a man presenting with low mood frequently has a sexual concern he hasn't raised, and vice versa. The practice handles both deliberately, because separating them creates a referral gap most men won't cross.
That gap is well-documented. Australian research finds 64.7% of men report at least one sexual difficulty, but only 17.6% seek help for it.1 Australian men with premature ejaculation self-treat for an average of 36.8 months before raising it with anyone — the longest delay in the Asia-Pacific region.2 A direct question from a GP is often what changes that.
Approaches used: CBT, ACT, DBT, EMDR, systemic therapy, plus evidence-based psychosexual protocols (sensate focus, stop-start and squeeze techniques, exposure-based work for performance anxiety, structured behavioural protocols for desire concerns). Postgraduate study in sexology is ongoing.
Who's a good fit — and who isn't.
Adult men experiencing mental health or sexual health concerns at a level appropriate for outpatient telehealth psychology. Men who have been sitting with something for months or years and want practical, structured work. Men who've tried therapy before and didn't find it useful, as well as those who've never been.
- Active psychosis or acute manic episodes
- Severe substance dependence requiring detox or intensive substance treatment
- Primary eating disorders requiring specialist multidisciplinary care
- Acute crisis or active suicidality requiring a higher level of care
- Anyone whose presentation requires inpatient or intensive outpatient management
- Couples work (individual sessions only — couples therapy training in progress, not yet offered)
- Patients under 18
If a referral isn't a fit, the intro call will pick that up and the patient will be referred on.
Standard MHCP, with the 1 November 2025 rules.
Standard MHCP referral by signed and dated letter. From 1 November 2025, MHCP referrals must come from a GP or PMP at the patient's MyMedicare-registered practice, or from the patient's usual medical practitioner (the GP or practice that has provided, or will provide, the majority of the patient's care over the relevant 12-month period).3
- Initial referral: up to 6 sessions
- Re-referral after the initial course: up to 4 more, capped at 10 individual sessions per calendar year
- Reviews and re-referrals from 1 November 2025 use standard time-tiered GP attendance items, not the dedicated review item (items 2712, 2713 and equivalents have been removed from the MBS)3
- The MHCP itself doesn't expire annually — only the referral runs out at 6 sessions
- Referrals dated before 1 November 2025 remain valid until the specified sessions are used
- Referrals can be addressed to Ben Waters or generically — patients are free to choose any eligible psychologist
Telehealth sessions are claimed under MBS item 91170 (50+ minutes, registered psychologist), with a $98.95 rebate per session.4
Sexual concerns and the Better Access threshold.
There's a common assumption that sexual difficulties don't qualify for an MHTP. The position is more specific than that.
The Better Access definition of "a mental disorder" — set out in MBS Online explanatory note AN.0.78 — is "a significant impairment of an individual's cognitive, affective and/or relational abilities which may require intervention and may be a recognised, medically diagnosable illness or disorder."5 The reference framework is ICD-10 Chapter V, with explicit exclusions only for dementia, delirium, tobacco use disorder, and intellectual disability.
The clinical test sits in the impairment, not in the diagnostic chapter.
A sexual difficulty on its own — no distress, no relational impact, no mental health consequence — generally won't meet the threshold. But that's rarely the presenting picture. Erectile difficulties, premature ejaculation, low desire, performance anxiety, and the rest typically come bundled with significant distress, relational impairment, performance-related anxiety, or low mood. Both DSM-5 and ICD-11 include clinically significant distress as part of the diagnostic criteria for sexual dysfunctions, and ICD-10 Chapter V includes sexual dysfunction not caused by organic disorder or disease (F52). Where that picture is present, the patient meets the Better Access definition and an MHTP is appropriate.
If a presentation sits in the edge case — a sexual concern with no associated distress or impairment — the intro call will help work it out, and a private-pay pathway is straightforward if MHTP isn't the right fit.
A short paraphrase you can use in the room.
- Free 10-minute intro call by phone, no commitment
- Reply by text by end of next business day with 2–3 specific times
- Typical wait: 2–3 weeks between intro call and first session
- 50-minute telehealth sessions via Zoom
- $200 standard or $160 concession; $98.95 Medicare rebate with an MHCP
What happens once the patient has the letter.
The patient phones for the free 10-minute intro call. If it's a fit, they're booked in.
Before the first session, they're sent a pre-assessment questionnaire, psychometric measures (typically DASS-21, the Sexual Distress Scale, plus one specific to the presentation), and the consent and service agreement.
Sessions run 50 minutes via Zoom Workplace, clinical configuration — passcodes, waiting rooms, end-to-end encryption, no cloud recording. AI-assisted note-taking (Heidi Health) is used with the patient's consent obtained at intake; sessions aren't recorded for replay, and patients can decline.
If the internet drops, the first instance is no charge; standard cancellation policy applies after that.
Letters at the standard points, plus ad hoc when needed.
Standard MHCP letters are sent after the initial course of sessions and at the end of the referral. Most patients prefer a high-level summary; the content can be discussed with the patient before sending.
For non-MHCP clients, communication with referrers happens only with the patient's explicit consent.
If you need a quick clinical update outside the standard letter cycle, email or phone is fine — see contact below.
The numbers, plain.
- Standard: $200 per session
- Concession: $160 per session (DSP, JobSeeker, Carer Payment)
- Medicare rebate (with MHCP): $98.95 per session, up to 10 per calendar year
- Out-of-pocket with MHCP: approximately $101 standard, $61 concession
- Private health: the practice doesn't claim directly; clients pay the full fee and claim back themselves
- Cancellation: 48-hour notice required; full session fee charged for under-48h or no-show
- Payment: via Halaxy with card on file (default) or invoiced bank transfer
Full fee detail: hardconversations.com.au/fees
Not a crisis service.
The practice is not a crisis service and is not staffed for after-hours support. Risk and safety planning happen within sessions where clinically indicated.
For acute risk, please direct patients to:
- 000 for emergencies
- Lifeline: 13 11 14
- Suicide Call Back Service: 1300 659 467
- MensLine Australia: 1300 78 99 78
Clinician-to-clinician.
For referral questions, clinical handovers, or anything else. For patient-facing booking, direct them to hardconversations.com.au/book.
Subject line "GP referral" or "Referrer enquiry" helps with triage.
PO Box 3159
Minnamurra LPO NSW 2533
Monday – Friday
9am – 6pm (AEST/AEDT)
- Mengesha Z, et al. Prevalence and correlates of sexual difficulties among Australian men: findings from the Ten to Men longitudinal study. 2025. (64.7% prevalence of any sexual difficulty; 17.6% help-seeking rate.)
- Park HJ, et al. Treatment-seeking behaviour for premature ejaculation: results from the Asia-Pacific Sexual Health and Overall Wellness study. 2016. (Australian men: average 36.8 months self-treatment before help-seeking.)
- Australian Government Department of Health, Disability and Ageing. Better Access redesign from 1 November 2025. MBS Online. (MyMedicare and usual medical practitioner requirements; removal of MHTP review and ongoing consultation items.)
- MBS Online. Item 91170 — Focussed Psychological Strategies, telehealth, 50+ minutes by an eligible psychologist. ($98.95 rebate, current as of April 2026.)
- MBS Online. Explanatory note AN.0.78 — Better Access Initiative. (Definition of "mental disorder" for Better Access eligibility; informed by ICD-10 Chapter V; excludes dementia, delirium, tobacco use disorder, and intellectual disability.)
Authored by Ben Waters, MProfPsych. Registered psychologist, Psychology Board of Australia (AHPRA: PSY0001961782). Last updated 29 April 2026.