South Australia’s mental health system so sick it’s on the verge of collapse, top psychiatrists say

SA’s top psychiatrists have warned “something bad is going to happen” because the state’s stretched mental health system is ready to collapse.

The state’s mental health system is on the “verge of collapse”, warn frontline psychiatrists who are at “breaking point” and are increasingly worried “something bad is going to happen soon”.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) says colleagues, mainly in the public sector, are concerned the continuing practice of early hospital discharge of mental health patients to improve emergency department waiting times will result in tragedy.

“We are under a lot of strain and a lot of psychiatrists keep saying that something bad is going to happen soon – it just can’t keep going on like this – we are at a breaking point; the system is on the verge of collapse,” said RANZCP SA branch chairman Dr Paul Furst.

His concerns come after parliament was told 15 mental health patients waited more than eight hours at the Royal Adelaide Hospital Emergency Department (ED) for treatment on Wednesday. This is not uncommon, says the SA Salaried Medical Officers Association and the Ambulance Employees Association.

Royal Australian and New Zealand College of Psychiatrists SA branch chairman Dr Paul Furst: “We are under a lot of strain and a lot of psychiatrists keep saying that something bad is going to happen soon.”

South Australian Health Minister Stephen Wade says the UMHCC, ten extra forensic beds, the MH CORE program and the Hospital in the Home beds service are among state government initiatives set up to divert ED demand. Photo: Russell Millard

Latest SA Health data shows there were 2325 metropolitan hospital ED presentations for mental health/drugs and alcohol last month – up slightly from last year and 260 more than 2019 – with substance misuse a growing factor.

Dr Furst said longer stay, non-acute rehabilitation beds for proper recovery, acute behavioural assessment units co-located near EDs and a prison mental health service were critically needed. More mental health beds and services has been at the top of the urgent action list of the Sunday’s Mail’s Let’s Talk campaign since launching in October last year.

“A very significant commitment – certainly many more millions is needed – and while the state government is to be commended for some of its work in mental health, it is still too little,” he said.

While the recent opening of the state-of-the-art Urgent Mental Health Crisis Centre (UMHCC) will bring some relief to ED demand, even at full capacity in May, it can treat only 18 people at a time. It is currently operating from 12pm to 12am.

Opposition health spokesman Chris Picton said the UMHCC needed to operate 24/7 and more beds and community services needed to be available.

Health Minister Stephen Wade said the UMHCC could be expanded in the future and was one state government initiative set up to divert ED demand. Others included ten extra forensic beds, the MH CORE program and the Hospital in the Home beds service. Mr Wade said mental health funding in SA had been boosted by almost $20 million in three years.

A state government election promise announced days ago to build a $700 million indoor entertainment arena in the CBD has been slammed by SA Best MLC Connie Bonaros as a “disgraceful waste of tax payers money” that should be directed to the ailing health and public housing systems.

If you or someone you know needs help call Lifeline on 131114 or Beyond Blue on 1300 224 636.

SA Health’s chief psychiatrist Dr John Brayley. Picture: NCA Newswire/Dean Martin

NEW ORDER ON MENTAL HEALTH BEDS

By Brad Crouch

The surge in demand for mental health beds has caused SA Health chief executive Dr Chris McGowan to issue an order giving Director of Mental Health Strategy, Dr John Brayley, total control of mental health bed management across the state including ambulance transfers.

The move is expected to be used at times of peak demand to manage patients and ensure they are not stuck in the system.

Recent demand has seen multiple patients warehoused in EDs after initial treatment for days on end due to no suitable places to move them to.

This has added to problems finding room for new arrivals to the hospital, which then contributes to ambulance ramping.

The Mad March festival season has also seen a surge in mental health presentations at the Royal Adelaide Hospital linked to city revellers taking methamphetamines.

Demand has left patients “warehoused” waiting for support. Picture: iStock

Dr McGowan said the order will remain in force until June 30 unless revoked. It applies to local health networks across the state as well as the SA Ambulance Service, allowing Dr Brayley to find suitable beds across all hospitals when needed.

“During periods of peak demand, SA Health’s Director of Mental Health Strategy will be responsible for the management of mental health beds and associated ambulance transfers,” he said.

“When the system is under extreme pressure, the Direction, issued by myself, will enable the Director of Mental Health Strategy, Dr John Brayley, to ensure the resources of our mental health system are optimised to meet the needs of patients.

“The Direction will only be enacted during periods of extreme demand and will only be used for short amounts of time. Local Health Networks will continue to manage patient flow on a day-to-day basis.

“To avoid doubt, this direction is not a direction concerning the clinical or medical treatment of any particular person.”

SA Health officials said there had been a range of actions to divert demand from EDs such as the recent opening of the Urgent Mental Health Centre in the city, expansion of the Hospital in the Home program and expansion of the MH-Co response teams, where mental health experts ride with ambulance paramedics with the aim of finding appropriate treatment as an alternative to an ED.