The Royal Australian and New Zealand College of Psychiatrists (RANZCP) and Australasian College for Emergency Medicine (ACEM) have called on the South Australian Government to get their house in order and get real about mental health.
Insufficient mental health services causing bed block in emergency departments (EDs) and contributing to overcrowding, long wait times for admission and resultant ramping is just the tip of the iceberg.
Chair of the RANZCP SA Branch, Dr Paul Furst, commented that the resignation of Adjunct Professor John Mendoza shows the disconnect between the government and the people trying to deliver mental health services on the ground.
'Our system doesn't have the capacity to meet demand. Add to that the increased demand due to COVID and the economic downturn and we desperately need more resources to rebuild mental health services in SA', said Dr Furst.
'Diversionary initiatives like the Mental Health Co-Responder program, Hospital at Home and a prison mental health service are operating at a limited capacity, but rapidly need to be fully operational right across Adelaide and expanded to regional centres.
'Even so, Adjunct Professor Mendoza was right in saying we need to address this at a systemic level. We will continue to have patients queueing for beds in EDs until the government unblocks patient flow by investing in rehabilitation beds, forensic beds and social supported housing.
'It is disappointing to hear the Minister attribute a surge in demand to methamphetamine use during the festival season, when South Australia has the highest per capita rates of methamphetamine use in the country. Where is the SA Health plan for managing methamphetamine use?
'At the ED level, co-located behavioural assessment units would go a long way to reducing overcrowding and lengthy wait times and provide a safe and appropriate setting for patients and staff.
'After the Oakden scandal, many senior managers and politicians said they had not been informed of the situation. After Adjunct Professor Mendoza's resignation, no-one can say they didn't know.'
ACEM SA Faculty Chair, Dr Mark Morphett added that for too long now emergency clinicians have been raising concerns about people presenting to the state's EDs in need of mental health support facing long and dangerous waits for more definitive care.
'We have been advocating strongly for years for systemic improvement for mental health patients with very little change. Adjunct Professor Mendoza's comments confirm our experience that there has been insufficient engagement at the highest levels to affect any sort of meaningful change,' said Dr Morphett.
'We urge the government to heed these warnings and step up to lead system improvements for the benefit of this growing population of patients.
'The ED should be a safe and supportive environment for all distressed and traumatised people, and models of care should draw on contemporary clinical practice for managing emergency mental health care.
'While there is much that we, as people working in the system, can do to improve the experience for people seeking help in a mental health crisis, we cannot do it alone. Dangerous delays in receiving definitive care are part of a widespread system failure across acute psychiatric and community based mental health.
'The government needs to step up and help us fix this completely unacceptable situation.'
The RANZCP SA Branch has called on the government to address these issues and other areas of urgent need in our mental health system in Prioritising South Australia's mental health – RANZCP SA Branch Budget Submission 2021-22.
The Nowhere Else to Go report, commissioned by ACEM and prepared by the Mitchell Institute for Education and Health Policy at Victoria University, analyses why the health system is failing to meet the urgent needs of people presenting to EDs for mental health care and presents a comprehensive set of recommendations for reform.
