Prince Charles Hospital’s mental health unit to be independently reviewed after patient suicides

Health Minister Shannon Fentiman says the state government is ready to implement the recommendations of an independent review into a hospital following the tragic suicides of three patients.

An independent review has been ordered into a Brisbane hospital’s mental health unit after three patient suicides in 16 months. Picture: Richard Walker

An independent review has been ordered into The Prince Charles Hospital’s mental health unit following three patient suicides in 16 months.

The head of mental health facility said the incidents were “devastating” and promised to review all areas, but he also described the “high and unrelenting” demand his unit is under in the face of patients with “an increasing complexity of mental health concerns”.

A Queensland Health spokeswoman confirmed the review would be led by an independent clinical expert and supported by an external panel of five, with the inquiry to be completed by the middle of the year and the findings released following the report being finalised.

The Head of the Royal Australian And New Zealand College of Psychiatrists’ state branch said he is not surprised by the developments, citing systemic underfunding of public mental health units despite practitioners stressing the increasing level of need for years.

A spokeswoman for Metro North, which includes The Prince Charles Hospital, said the review will look at possible improvements to the mental health unit to “ensure greater robust care measures to protect vulnerable inpatients”.

Health Minister Shannon Fentiman confirmed the state government stood ready to implement recommendations from the hospital’s review, with a report due back mid-year.

“It’s always incredibly distressing to lose a loved one and we’re working very closely with those families as part of this review,” Ms Fentiman said.

“After any incident, there is always a clinical review and we have made a number of improvements to the model of care including additional frontline staff, and there will be an additional short stay unit – a crisis stabilisation unit – that will open in September.

“But the hospital and health service has taken the position that they want to look systemically across the model of care.”

Health Minister Shannon Fentiman says the state government has made improvements to its model of care following three patient deaths by suicide at Prince Charles Hospital. Picture: Liam Kidston

In a statement, Metro North Health offered its “sincere” condolences to the affected families.

“Tragically, some patients have passed away while in the care of the unit, necessitating a review into what can be done better,” the statement said.

“Metro North Health remains in contact with the families impacted with a commitment to mitigate instances of this occurring through the review process and its findings.

“Metro North Health is aware that mental health demand has outstripped population growth with post-pandemic demand for crisis and suicidal presentations to Emergency Departments much higher than pre-pandemic.

“This, compounded with financial stressors and limitations to access private care and psychiatry, sees Metro North Health services busier than ever with acute mental health presentations.”

RANZCP Queensland Branch chair Professor Brett Emmerson said he had heard about the suicides at The Prince Charles Hospital’s unit, but did not know specifics.

“You would hope this prompts change, but this has happened before, there have been deaths in other public mental health units and at this stage it hasn’t prompted the change that is required,” he said.

“I’d be sceptical that the government would listen.”

Professor Brett Emmerson, chair of RANZCP Queensland Division. Picture: Supplied.

Professor Emmerson said the state had a critical staff shortage, a lack of experienced staff, and outdated inpatient public facilities.

“The inpatient units at Royal Brisbane and Women’s Hospital, the Princess Alexandra Hospital, and The Prince Charles Hospital were all built in the 1990s or early 2000s, it is simply not possible to provide contemporary mental health care in those units,” he said.

“The state government has put some money into mental health, but I’d say it is only 60 per cent of what is required.

“We’re still around $330m short – we need to refurbish the mental health units at those three hospitals, we also need a further 370 more beds, and a further 2000-3000 community mental health staff are needed too.

“There’s a lot wrong with the staffing levels and level of accommodation – most inpatient mental health units have nurses with 4-5 years’ experience, but 10 years ago there were staff in there with 15-20 years’ experience.”

The Prince Charles Hospital’s mental health unit director Dr Hitesh Joshi said the demands on his unit and the mental health service are “high and unrelenting”.

“The events that have occurred at TPCH are devastating and not what any of us would expect when vulnerable patients come into hospital,” he said in a statement to The Courier-Mail.

“Patients are presenting with increasing complexity with a range of mental health concerns requiring urgent care.

“Staff are working very hard every day to manage the challenges in an environment where we are dealing with significant workforce shortages across the sector. Other pressures such as homelessness and lack of community resources is exacerbating the issue.

“While there has been investment in mental health, it will take time to increase the bed capacity to match the demand, and we will need to look at alternative options within our public mental health services to manage this demand safely.

“We have welcomed increased staffing as a first step to assist in ensuring we are optimising the care we provide to our patients.”

Mental health support organisation SANE chief executive Rachel Green said, sadly, patient suicides do happen in public and private hospitals’ mental health units across all jurisdictions.

“Suicide in care is a persistent challenge, we see it in all states and territories, but it is not something that is typically disclosed,” she said.

“The big question is why are people ending up in hospitals in the first place? Why aren’t they getting that support earlier on?”

Ms Green was pleased to see the $588.5 million in Tuesday’s Federal Budget for a free no-referral digital mental health service, but more is needed.

“For example, we would like to know how many people in Australia have schizophrenia, the last national survey was done in 2007,” she said.

“Particularly in the wake of this story in Queensland and also the Bondi Junction stabbing, the whole sector and the community have been advocating for more support for those with complex mental health needs.

“There used to be programs around the country to support these people, but then they were rolled into NDIS, and then NDIS was under review, and there has been no commitment to answering how we support those with complex needs.

“We need better staffing levels, better inpatient unit design, better evidence-based training, and improved technology support for staff.”

Queensland Mental Health Commissioner Ivan Frkovic said the state government invested $11.5 million in response to the state’s suicide rates, and released phase two of a decade-long suicide prevention plan.

“The initiatives build on the progress over the last few years in Queensland, which have been progressed by Queensland Health under Better Care Together.

“This includes the establishment of a number of Crisis Support Spaces that provide a combination of peer and clinical support to people in suicidal distress, as an alternative to emergency department care.

“Aftercare support for people after presentation to an Emergency Department is also a crucial element in suicide prevention that Queensland is investing in.”