Page 678 - Week 02 - Thursday, 20 February 2020
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(9) What is the current ratio of mental health beds, including acute and community-based beds, per 100 000 population in the ACT.
(10) What is the government doing to bring that figure up to the ratio of 41 beds per 100 000 population that the College believes is appropriate.
Mr Rattenbury: The answer to the member’s question is as follows:
(1) Canberra Health Services is unable to quantify a percentage increase in infrastructure or human resources. However, since 2014 funding has been received for an additional five low dependency beds (35 to 40 beds) at the Adult Mental Health Unit (AMHU), with an approximately an additional 14 FTE.
A number of strategies have been introduced including:
o Patient Flow Coordinator
This role has provided increased visibility of bed capacity across the system (including Calvary) and supported a proactive approach to increasing movement of patients. This includes twice daily bed capacity reporting including all inpatient units and identification of patients suitable to be cared for in other settings. This enables creation of capacity for High Dependency Unit (HDU) beds in particular.
o Dedicated Consultant Psychiatrist in Emergency Department
Traditionally the ED interface has been managed by a registrar with support from consultants from the Consultation Liaison Service and AMHU. A dedicated consultant has been allocated full time (business hours Monday to Friday) to enable timely assessment and planning for people presenting with mental health conditions. This has enabled better relationships with the ED consultants.
o Cross Directorate Forum with Justice and Community Safety Directorate (JACS) including Emergency Services
Regular meetings have been established to identify and progress issues impacting across services with an aim to streamlining processes which impact both emergency services and the ED. Working with Emergency Services will provide the opportunity to review the current processes for transfer to ED under an Emergency Action (EA). The development of the PACER model will also assist in addressing this situation.
o Consideration of alternative approaches to S309 assessment
In collaboration with the Chief Psychiatrist, alternative approaches will be investigated including the feasibility of undertaking these assessments at the Court rather than transferring to Canberra Hospital ED for assessment. Approximately 50 per cent of people referred for a S309 Assessment do not require admission.
o Creation of a four-bed area within ward 7B
Ward 7B at Canberra Hospital is a medical ward which often accommodates patients with physical health conditions and concurrent mental illness. These physical problems are often associated with their mental illness (e.g. suicide attempts or eating disorders). There is a four-bed pod within the ward that has been identified as suitable and used intermittently for “surge” capacity for mental health patients. A risk assessment has been undertaken to ensure the environment is deemed safe and ligature risks minimised.
Despite the above strategies, management of some individual patients remains difficult, particularly in relation to those requiring seclusion and sedation in the Emergency Department. This creates challenges for their safe transfer to the HDU in AMHU. For example, when patients are particularly aggressive and require significant
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