The push to turn Queensland's mental health strategy on its head

Three years ago, Lyndall Baker’s life fell apart.

She was 47, in a senior administrative role at an engineering company, with close friends, a good social life and a daughter making her way as a lawyer.

Lyndall Baker helps open the new mental health facility Nundah House in Brisbane.Credit: Jorge Branco/Fairfax Media.

Within six months, her life was unrecognisable. She was diagnosed with major depression and anxiety and spent five days in the Royal Brisbane and Women’s Hospital mental health unit.

As “horrible” as that was, it was the mother-of-one’s first step on the road to recovery.

But it probably wasn’t what the Brisbane woman, who had to take real steps to deal with the loss of her former "very regular life", needed at the time.

“It was quite scary to be honest, and didn't really help my condition, other than to have a bed and meal provided,” she said, a sentiment echoed by expert psychiatrist Associate Professor Brett Emmerson.

“It was beyond confronting.”

Five days later, Ms Baker was discharged. But again, that release straight from hospital to home was probably not what she really needed at the time.

For years in Queensland, there has been a large gap between hospital treatment for patients suffering severe mental illness and returning home for care in the community.

“It is a pretty big gap,” Ms Baker said.

“I've never actually tried to kill myself but I’ve had intermittent suicidal ideation, which is very distressing, but have never acted on it.

“What makes that worse all the time is the lack of facilities, support. That gap has very nearly taken my life.”

An outdoor area at short-stay mental health centre Nundah House.Credit: Jorge Branco

But it is a gap the Palaszczuk government is now fighting to address as a “key plank” of a possible overhaul of the mental health system aimed at turning current paradigms on their heads.

On Thursday, Ms Baker helped open a $5 million, 10-bed, short-stay centre in the city’s north, which she and other mental health “consumers” were closely involved with planning.

Speaking quietly, if sometimes haltingly, to a small room of people, the 50-year-old was calm and confident enough that she had to remind people of how hard the experience was to go through on the inside.

Tucked away in a soon-to-be-gentrified strip of construction just off Sandgate Road, Nundah House is one of four facilities of its type to open across Queensland by early 2019, with three six-bed youth centres also in the works.

(From left) Metro North Hospital and Health Service board deputy chair Dr Kim Forrester and Associate Professor Brett Emmerson.Credit: Jorge Branco

Older “step up, step down” facilities are already in operation in Logan and Cairns, catering to people who need too much care to return home but are not unwell enough to need hospital treatment.

Associate Professor Brett Emmerson, the Metro North Mental Health executive director, said he believed about 10 more of the units were needed across the state.

Beyond helping to plug the treatment gap, they were cheaper than $1500-a-day hospital beds and would free up acute resources for those who need them more.

Nundah House.Credit: Jorge Branco

“The step up means that somebody like Lyndall who had her first depressive episode, she could quite easily have been admitted here for those five days, rather than going to an acute unit.

“The other thing about the acute units is increasingly we have people who are high on amphetamines, are largely occupied by males aged between 30 and 50, who have psychotic illnesses.

“If I was having my first psychotic episode I’m not sure I’d like to be in with those. It will give you a wrong idea of how your illness could turn out.”

(From left) Metro North Hospital and Health Service board deputy chair Dr Kim Forrester, Health Minister Steven Miles and Member for Nudgee Leanne Linard.Credit: Jorge Branco.

Health Minister Steven Miles said it was difficult to put an exact number on how many facilities would be needed but his department aimed to roll out enough to meet demand.

The evolving approach to treatment, a feature in Victoria for more than a decade, is reflective of a push to reform Queensland’s entire mental health treatment framework.

Mental Health Commissioner Ivan Frkovic has been charged with the overhaul, and is due to deliver a new strategic mental health strategy to the government in July.

“I think the whole system is geared towards hospital care and I think a fundamental shift in the treatment side of the system is really around community care,” he said.

“This provides an option for community care and I think we’ve got to shift the whole system.

“Hospital beds should be the last resort option, not the first resort option.”

He agreed the mid-way facilities were a “key plank”, saying another major focus would be early intervention, helping people before they became acutely unwell.

It was another feature Ms Baker would have loved three years ago when she was coming to grips with the frightening world of her condition for the first time.

“People around me, at home, at work, they didn't know what my symptoms where,” she said.

“If I had a cast on my arm, they would have said, ‘oh, you’re having pain from your injury but they couldn't see the pain and suffering that I was going through.

“So it took a long while before I completely fell in a heap.”

Ms Baker, who has worked with other organisations dealing with mental health in the past, wants to keep doing so into the future to help others in her situation.

If you need help or support contact, Lifeline: 13 11 14, beyondblue: 1300 22 4636, Kids Helpline: 1800 55 1800 (24/7 crisis support), or headspace: 1800 650 890 www.headspace.org.au.