SA’s mental-health care for kids and teenagers is desperately lacking | Jess Adamson

“I’ve tried, we’ve all tried,” he told his mother. The phone call sparked a race against time to save his life – and revealed a huge gaping hole in SA’s health care.

Six weeks ago, a friend answered a phone call from her 17-year-old son.

Her son was at work, calling in his lunch break.

“I can’t do it,” he said.

“I’ve tried, we’ve all tried. I’m so grateful for what you’ve done but you need to give me permission to ….”

It was a devastating phone call. This caring, funny, curious and loyal young man wanted to end his life.

He’d lived with depression for several years and was sick of trying to find his way through.

He’d run out of hope and light.

He’s not alone. We know that one in five Australians has a mental-health issue and that 50 per cent of mental illness onsets between the ages of 11 and 14.

But what upsets me the most about this young man’s story is that, at his most vulnerable, he asked for help and we simply weren’t there for him.

Time and again he bravely put his hand up and admitted he wasn’t OK. But there are giant gaps in our adolescent mental-health system, and he didn’t get the support he needed. His family, like thousands of others, struggled to get into a psychiatrist.

In his darkest moments, when his life was in danger, they took him to the Women’s and Children’s Hospital emergency department where he’d wait hours to be seen, before being assessed in 10-15 minutes and sent home again.

“I have great admiration for the people working in the emergency departments but I felt like they weren’t equipped to deal with the complex issue of adolescent mental health,” his mother says.

“He’s mature, he’s very aware of the issues, he’s able to identify when he’s at risk but they’d discharge him within hours, they didn’t have any place for him.

“We were back to trying to manage him on our own. It was terrifying.”

In no way are the doctors and clinicians at the WCH to blame here.

If your child was in an accident it’s the only place you’d want them to be. They provide magnificent care for physical injuries but the health system is not equipped to manage our growing adolescent mental-health emergency. Yet the reality is, it’s the only place for adolescents with a mental-health emergency to go right now.

The Urgent Mental Health Care Centre on Grenfell St is open 24/7 but when my friend called them on one particularly bad night with her son, she was directed to the WCH.

South Australia’s chief psychiatrist Dr John Brayley concedes the need to do better.

“Yes, there is certainly a gap. Our practitioners are delivering the services for people both in crisis and in emergency but we recognise for children, adolescents and young people that there are gaps in the amount of services available,” he says.

“There’s a need to redesign and improve services. At this point, the extra resources that are going into child and adolescent services are much needed.”

Those extra resources include commitments of five additional child and adolescent psychiatrists, 10 extra child and adolescent psychologists and six new mental-health nurses.

The current Mental Health Services Plan includes a youth residential service, allowing patients to stay and be offered step-down support as they leave.

“I would expect that sometime in the future this type of unit will be available in South Australia,” Dr Brayley says.

Sometime in the future will be too late for some. What are we waiting for? Right now, some of the smartest people in the country are designing our new WCH. Surely this is the opportunity to get serious about the way we care for our most vulnerable young people in their time of need.

A chaotic ED in a children’s hospital bursting with broken arms and hurt knees is not the place we should be taking 17-year-olds whose lives are hanging in the balance.

SA has the highest rate of mental-health-related presentations to ED’s in the country.

We know some young people aren’t seeking help at all because there’s no clear pathway for them – and yet the MHSP stresses the importance of early intervention to minimise the lifelong impact.

SA Health Chief Psychiatrist Dr John Brayley. Picture: Dean Martin

And so back to my friend’s phone call from her son. You can imagine her pain as he asked for her blessing to leave, but somehow she remained calm and got him home.

“I am your mother and I will never give you that permission,” she said. “I will never stop trying to find a way.”

That same afternoon she heard about USpace in Sydney, Australia’s first private mental-health service targeted to the needs of young adults aged 16-30.

The 20-bed facility, next to St Vincent’s Hospital, provides personalised care in a safe, therapeutic and engaging environment for up to three weeks at a time. All my friend needed was her son to agree – and a referral from a GP. The first bit was easy, he wanted to give it a try and after a formal interview, he was accepted by USpace to begin the following week. The referral was the hard part – my friend was told the wait for a GP was 10 days.

“It was touch and go whether he would choose to stay alive long enough to get there,” she says. “I told the GP clinic this is critical, I don’t care who we see but I’ve got to get this referral. No one would see me.”

Her son initially lost his spot at USpace but two weeks later he was on a plane. He was comprehensively assessed on day one, had his medication tweaked and he’s spent the past 2.5 weeks there developing strategies and coping mechanisms to help manage his depression.

There are daily workshops run by highly skilled experienced mental-health practitioners including psychiatrists, psychologists, occupational therapists and nurses.

No South Australian family should have to travel to Sydney for urgent health care. My friend and her husband rented an apartment to support their son, taking turns to be with him while looking after their other children at home. Not everyone is able to do that.

Dr Brayley agrees the innovative facility could make a difference here.

“I think we need to consider this type of model in the future,” he says.

“We do need a longer-stay unit – there are discussions at the moment where we’re going to be consulting the community.”

My friend’s son is home now and grateful for the care he received.

He says living with other adolescents facing serious challenges was an eye-opener but an important part of the healing process.

And while it’s early days, he feels better equipped to manage his illness and is in a far better place than when he entered the clinic.

He’s able to go back any time to continue his journey and for the first time in five years, thanks to the clinic, his parents feel a sense a safety and true hope for their son.

From his Mum …

“I do feel like this clinic has saved his life,” she says. “Having a child with depression can sometimes feel like you’re going through some of the emotions of grief. I’ve been angry, sad and certainly in denial – you grieve the happy child you once had, you long for the sound of their laughter or glimpses of the smile they used to show.

“And every now and then, you have a glimmer of hope when you see a small part of their happy-self emerge. And that is the best feeling ever.”

For help, call Beyond Blue on 1300 224 636 or Lifeline Australia on 13 11 14