Page 1264 - Week 05 - Thursday, 4 June 2020
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and at times it is at 105 per cent capacity, while the target for the hospital is 90 per cent occupancy, and that is at the top of the range. The adult mental health unit simply does not have enough beds to cater for the demand. Although the minister says we have enough staff, I am concerned about whether we have enough staff. This pressure continues, even after four additional beds were commissioned in this financial year’s budget. Given that its clientele are often suicidal or likely to harm themselves or others, the adult mental health unit needs more staff than most of the other areas in the hospital per patient. We need an inquiry to determine whether our mental health system has enough resources to meet community needs. The incoming minister’s brief prepared for Minister Stephen-Smith shows that there are 339 people who waited for a day or more in the ACT emergency department as of May 2019. This compares to 144 in the previous year, so there has been 139 per cent blowout in this one statistic.
Canberra Health Services advised the Minister for Health, in the incoming minister’s brief, that the average bed block minutes remains significantly higher than for non-mental health patients. It said:
This is once again reflective of the capacity constraints of the adult mental health unit, and is also reflected in the number of mental health patients whose length of stay in the emergency department is greater than 24 hours.
That was in 2019. In October 2018 the Australasian College for Emergency Medicine hosted a national health and emergency department summit. I had wished to go to that but it was a sitting day and I could not. My senior adviser attended in my stead, as did many ACT government representatives. Following the summit, delegates issued a unanimously approved communique which identified seven key principles. Principle 5 states:
No one should stay longer than 24 hours in the emergency department, particularly those most vulnerable members of the community.
It is also worth quoting key principle 6:
More work needs to be done to build and sustain a functioning, integrated, mental health system that supports the prevention, early intervention and better management of mental health crises. There is not enough capacity in either hospitals or the community.
Key principle 7 identifies people living with mental health conditions, their advocates, healthcare providers and governments as having an important role in addressing what the communique described as “a crisis”. It is interesting to note that the Royal Australian and New Zealand College of Psychiatrists has described the ACT mental health system in the same terms—as a system in crisis.
The problem with the mental health system is not self-contained. It is causing problems in our health system as a whole. This does not mean that these problems are due to staff. Our mental health staff do a very difficult job. Being a mental health nurse or a mental health practitioner of any sort is an exacting job that most of us would not take on. They do a difficult job, facing a high risk of assault and the
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